A systematic review of preventive chemotherapy against soil-transmitted helminth infections in Southeast Asia: Combination therapy, enhanced WASH, and integrated health education to accelerate control

A systematic review of preventive chemotherapy against soil-transmitted helminth infections in Southeast Asia: Combination therapy, enhanced WASH, and integrated health education to accelerate control | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Systematic Review A systematic review of preventive chemotherapy against soil-transmitted helminth infections in Southeast Asia: Combination therapy, enhanced WASH, and integrated health education to accelerate control Jan Clyden Tenorio, Alok Kafle, Muhammad Fikri Heikal, Prasert Saichua, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7089344/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Soil-transmitted helminth (STH) infections continue to pose a significant health threat in Southeast Asia, where a third of global infections are estimated to occur. Preventive chemotherapy (PC) through mass treatments has been recommended by the World Health Organization (WHO) to combat infections and their dire consequences in susceptible populations. This review aims to update PC efforts for STH infection control in Southeast Asia. We systematically searched MEDLINE via PubMed, ScienceDirect, Scopus, EBSCO Host, and ProQuest using specific terms for papers published from 2011 to 2025. From the 4294 initial search hits, 27 studies were included in this research. All Southeast Asian countries, except Brunei Darussalam and Singapore, were represented. Benzimidazole (BZ) drugs, Albendazole (400 mg) and Mebendazole (500 mg), were the most used drug interventions in PC efforts. BZ treatment effectively reduced STH prevalence and intensity, reinforcing its role in control programs. However, recent research showed that BZ treatments failed to reduce infection prevalence and had diminished efficacy. Combination therapies, such as Ivermectin (200 µg/kg) + Albendazole (400 mg), enhanced treatment outcomes across STH species. Integrating health education and WASH improvements further strengthened infection control alongside PC. Combination therapy with health education and WASH improvement can accelerate control and elimination. Our review provides valuable insights for strengthening STH control programs in SEA, advocating for a multi-faceted approach informed by current evidence. Parasitology Mass Drug Administration Neglected Tropical Disease Benzimidazoles Public Health Programs Figures Figure 1 Figure 2 1. Introduction Soil-transmitted helminth (STH) infections remain a significant threat to public health in endemic areas in tropical and subtropical climates. 1 The World Health Organization (WHO) estimates that around 1.5 billion people are affected, approximately a quarter of the global population. 2 Recent data from the 2021 Global Burden of Disease study indicate that there are approximately 642 million cases worldwide, which account for 1.38 million DALYs (disability-adjusted life-years). 3 The age-standardized prevalence is 8429.89 per 100,000 population, representing a 70% drop from the 1990 data. 3 These infections are caused by Ascaris lumbricoides, Trichuris trichiura , hookworm species like Necator americanus and Ancylostoma duodenale , and Strongyloides stercoralis. 4 Ancylostoma ceylanicum is a zoonotic hookworm that affects companion animals and humans in the Asia-Pacific region 5 . Southeast Asia (SEA) is a hotspot for STH infections, accounting for one-third of all reported cases globally. 6 A 2008 WHO report documented that STH infection prevalence exceeded 50% in some areas of Cambodia, Indonesia, Myanmar, the Philippines, and Vietnam. 7 A 2018 systematic review found that the prevalence of A. lumbricoides exceeded 20% in Myanmar, the Philippines, Malaysia, and Indonesia, while hookworm infections surpassed this threshold in those countries plus Cambodia. 8 Also, a recent analysis indicates that T. trichiura affects over 685 million people in SEA, with a pooled prevalence of 20.95%. 9 The latest Philippine national survey showed STH infection prevalence 8% above the 20% national target, and moderate-to-heavy infections over 30% above the 2% target. 10,11 Recent studies in Myanmar and Vietnam, using qPCR and Kato-Katz smears, respectively, revealed alarmingly high rates of STH infections in schoolchildren, with 78.8% infected in Myanmar (predominantly A. lumbricoides and T. trichiura ) and 76.1% in Vietnam. 12 , 13 In Malaysia and Thailand, persistently high STH infections in indigent and tribal communities remain a significant health problem, especially among children living in these remote and rural areas. 14 , 15 STH infections have had a shared history with the countries in SEA. Hence, it is not surprising that various efforts to control these parasitic health threats have been implemented across the region. STH infections pose a significant health threat to vulnerable segments of the population within endemic regions, particularly schoolchildren, women of reproductive age, and immunocompromised individuals. 1 , 4 Among children, pathologic consequences of infection include iron-deficiency anemia, stunting, malnutrition, cognitive development issues, and motor deficits. 4 , 16 , 17 The severe effects of high-burden infections among schoolchildren led to efforts towards control, elimination, and prevention of STH infections in this vulnerable population. 18 The cornerstone of these efforts has been Preventive Chemotherapy (PC) with Benzimidazole (BZ) drugs through Mass Drug Administration (MDA) programs. 18 , 19 Control and elimination efforts against STH aim to reduce infection prevalence, lower pathologic consequences of infections, and prevent reinfection. 18 , 20 , 21 Nearly 900 million pre- and school-aged children around the world require PC against STH infections based on 2023 WHO data. 22 The 2018 WHO data showed that several endemic SEA countries had varying levels of PC coverage: Indonesia did not reach 75%, the Philippines and Vietnam achieved over 75% but for less than five years, and only Cambodia, Lao PDR, and Myanmar sustained coverage above 75% for more than five years. 21 Among the same countries, the 2023 WHO data on PC coverage in pre- and school-aged children showed that only Indonesia, Myanmar, Cambodia, and Vietnam achieved the target 75% benchmark. 22 Meanwhile, the Philippines at 29.73% and Lao PDR at 57.05% lagged behind. 22 SEA nations have demonstrated a sustained commitment to combating STH infections through various control programs and MDA initiatives. Significant disparities in coverage and long-term success highlight the ongoing challenges of achieving consistent and equitable elimination across the region. The fight against STH infections remains a difficult and ongoing process in endemic SEA countries. Trends and developments in these control and elimination efforts need to be assessed to forge the most appropriate path towards achieving national and global elimination targets. 2 , 11 , 23 Hence, the objective of this comprehensive review is to provide an update on drug-based control and elimination efforts for the control and elimination of STH infections in SEA by summarizing and analyzing findings from peer-reviewed research. Here, we analyzed research published between 2011 and 2025 to document trends in PC using mono- and combination drug administration, presented the value of integrated control efforts that include health education and WASH, and highlighted research indicating diminished efficacy of MDA efforts from many countries of the region. 2. Materials and Methods 2.1. Research Questions This systematic review aimed at answering the following research questions: Which SEA countries have implemented drug-based STH control efforts, as reported in peer-reviewed literature published from 2011 to 2025 What drugs have been used as interventions in these control efforts? What were the treatment outcomes of drug administration in controlling infections in these countries? 2.2.Search Strategy Six databases were searched in this systematic review. Medline via PubMed ( https://pubmed.ncbi.nlm.nih.gov/ ), Scopus ( https://www.scopus.com/sources ), Science Direct ( https://www.sciencedirect.com/search/entry ), EBSCO Host ( https://search.ebscohost.com/ ), and ProQuest ( https://www.proquest.com/ ) were searched for literature [Accessed 7 to 11 February 2025]. All database searches were restricted to the publication date from January 2011 to January 2025. This time restriction was chosen to provide a follow-up to the review on the same topic by Jex et al. 6 This review is limited to the member countries of the Association of Southeast Asian Nations (ASEAN). For EBSCO Host, the Applied Science and Technology Source Ultimate, CINAHL Complete, MEDLINE, and Newswires databases were selected. The specific terms used to search the databases can be found in Supplementary Table 1. The .ris and .nbib files of the searches were downloaded. 2.3. Study Screening, Selection, and Eligibility The search results were uploaded to Rayyan ( https://www.rayyan.ai/ ), where study selection, screening, and eligibility checking were done [Accessed 14 to 21 February 2025]. Rayyan is an AI-assisted platform for streamlining study screening, provides a robust collaboration tool, and the ability to import and deduplicate references from various sources 24 . The platform was used for duplicate detection, with 95% text similarity as the resolution limit. Duplicates with < 95% similarity were resolved manually. The titles and abstracts were used for the initial screening, and papers lacking these components were excluded. The detailed inclusion and exclusion criteria used for assessment are mentioned in Supplementary Table 2. The first, second, and third authors conducted the study selection, screening, and eligibility, and all authors collaboratively resolved disagreements to reach a consensus. Figure 1 provides an overview of this review's study selection, screening, and eligibility process. 2.3. Risk of bias assessment, data extraction, and synthesis The papers that passed the eligibility assessments were of several types: cross-sectional and quasi-experimental studies, and randomized controlled trials. Due to this diversity of study types, several risk-of-bias tools were utilized. The Joanna Briggs Institute’s Critical Appraisal Checklist for Analytical Cross-Sectional Studies, Critical Appraisal Checklist for Quasi-Experimental Studies, and Critical Appraisal Tool For Assessment of Risk of Bias for Randomized Controlled Trials were used ( https://jbi.global/critical-appraisal-tools ). The second and third authors independently reviewed the risk of bias assessment. The fourth and fifth authors resolved disagreements. The results of the risk of bias assessment are provided in Supplementary Figs. 1–3. The included papers were given codes (Supplementary Table 3). Several data were extracted from the included studies. These include authors’ names, year of publication, title, type of study, specific locale and country of the study, population, STH species studied, drug-based intervention, comparison groups (if any), test used, and their key outcomes. These were input into a spreadsheet. The study results were described, summarized, and synthesized using descriptive statistics, specifically counts and percentages. 3. Results and Discussion 3.1. Characteristics of the studies included Six databases were searched, and a total of 4294 hits were retrieved (Fig. 1 ). Of these, 67% were removed due to duplication. The initial screening of 1244 articles resulted in a 97% removal rate, with exclusions based on publication type (reviews and abstracts), study location (outside SEA), pathogen focus, publication date (outside January 2011 to January 2025), incomplete metadata (no authors/abstract), and language (non-English). Eligibility screening was conducted on the full text of the remaining 41 papers. 34% of these were excluded due to having the wrong study design and outcome. 27 papers were included in the study, and all of them passed the risk of bias assessment (Supplementary Figs. 1–3). The included studies span all the countries of SEA, except Brunei Darussalam and Singapore, where PC is not required 22 (Fig. 2 A). Lao PDR had the highest number of studies with six, followed by Myanmar, Indonesia, and the Philippines with four. Three studies were conducted in Timor-Leste, while two studies each were done in Thailand, Cambodia, and Vietnam. Malaysia was represented by one study. Of these countries, Thailand and Malaysia do not require PC. 22 Studies were done both in schoolchildren (i.e., pre- and school-aged) and community folks. Among the STH studied, the most represented was T. trichiura , followed by A. lumbricoides and hookworms. Most of the studies included in this review were analytical cross-sectional studies, followed by randomized control trials with quasi-experimental studies being the least represented. BZ drugs, particularly Albendazole (400 mg) (ABZ) and Mebendazole (500 mg) (MBZ), were the most frequently employed interventions for MDA in the included studies. Combination therapy, where drugs from different classes of anthelmintic are combined to expand the range of activity and increase efficacy, has also been an emerging trend in the included studies. BZ drugs were combined with Macrocyclic lactones like Ivermectin (IVM) 25 and Pyrimidine derivatives like Pyrantel pamoate (PYR). 26 Likewise, the combination of drugs to integrate the control of numerous parasitic helminths of public health importance was also reported. For instance, the combination of ABZ, IVM, and diethylcarbamazine (DEC) against lymphatic filariasis, scabies, and STH has been trialed regarding its effect on infection prevalence reduction. 27 Comprehensive control efforts that integrate drug-based interventions with health education, provision of clean water, and improvement of sanitation and hygiene standards have also been reported by the studies included. 28 , 29 The effects of these interventions are provided in the following section. Key information regarding the included studies is summarized in Tables 1 and 2 Table 1 Key results from randomized controlled trials and quasi-experimental studies included in this review. Reference and Year of Publication Country Study Design Location Population STH studied MDA Interventions (Dose) Comparison group Test Used Key Outcomes Soukhathammavong et al. (2012) 30 Lao PDR Randomized controlled trial Batieng district, Champasak Province Children aged 6–12 years old Hookworms, Ascaris, Trichuris ABZ (400 mg) MBZ (500 mg) Kato-Katz thick smear Hookworms: ABZ CR-32.0% ABZ ERR-86.7% MBZ CR-15% MBZ ERR-76.3% Ascaris : ABZ CR-92.9% ABZ ERR-100% MBZ CR-93.3% MBZ ERR-100% Trichuris : ABZ CR-33.3% ABZ ERR-67% MBZ CR-27.9% MBZ ERR-66% Monse et al. (2013) 29 Philippines Quasi-experimental study Camiguin and Misamos Oriental Provinces First-grade students (6–7 years old) of public elementary schools STH (taken together) ABZ (400 mg), daily supervised brushing with a fluoride toothpaste External concurrent control groups and Internal non-concurrent control groups Kato-Katz thick smear Intervention arm: 10.7% reduction in the prevalence of STH moderate-to-heavy infection Control arm: 12.4% reduction in the prevalence of STH moderate-to-heavy infection Levecke et al. (2014) 31 Cambodia and Vietnam Randomized controlled trial Cambodia and Vietnam Schoolchildren aged 4–18 years Hookworms, Ascaris, Trichuris MBZ (500 mg) ABZ (400 mg) McMaster egg counting method Ascaris : ABZ – 100% FECR in Vietnam BZ – 93.9% FECR in Vietnam Trichuris : ABZ – 92.3% FECR in Vietnam MBZ – 76.8% FECR in Vietnam Hookworms: ABZ – 97.6% FECR in Cambodia MBZ – 79.7% FECR in Cambodia ABZ – 100% FECR in Vietnam MBZ – 95% FECR in Vietnam Park et al. (2016) 32 Indonesia Quasi-experimental study Gunungpati sub-district, Semarang, Central Java Children between the ages of 3 and 13 years STH (taken together) ABZ (400 mg), BALatrines No intervention Sodium nitrate fecal floatation technique STH prevalence: Control arm – 20.4% Intervention arm – 4% Clarke et al. (2018) 28 Timor Leste Randomized controlled trial Aileu and Manufahi municipalities Community-wide and school children Hookworms, Ascaris, Trichuris Community-wide ABZ (400 mg) MDA and WASH ABZ (400 mg) MDA and WASH only in schools Real-time multiplex PCR Control Arm Prevalence: Ascaris - 48.7% Trichuris – 2.2% N. americanus - 13.7% Intervention Arm Prevalence: Ascaris - 7.6% Trichuris – 1.9% N. americanus – 15.1% Sapulete et al. (2020) 33 Indonesia Randomized controlled trial Bangli, Bali 8–12 years old children Trichuris ABZ(400 mg) and PYR (10 mg/kg ) for 3 consecutive days ABZ(400 mg) for 3 consecutive days Kato-Katz thick smear Control arm CR: 40% Intervention arm CR: 60% Control arm % Satisfactory ERR (≥ 50%): 44.7% Intervention arm % Satisfactory ERR (≥ 50%): 55.3% Keller et al. (2021) 34 Lao PDR Randomized controlled trial Nam Bak district in Luang Prabang Province Community-wide, aged six to 60 years Hookworms, Ascaris, Trichuris ABZ (400 mg) and IVM (200 µg/kg) ABZ (400 mg) Kato-Katz thick smear 14 to 21 days ERR: Control arm – 68.8% Intervention arm – 99.2% 6 mos ERR: Control arm – 79.6% Intervention arm – 99% 12 mos ERR: Control arm – 91.3% Intervention arm – 99.6% Mationg et al. (2022) 35 Philippines Randomized controlled trial Laguna Province Schoolchildren aged 9–10 years Any STH ABZ (400 mg) MDA with Magic Glasses ABZ (400 mg) MDA with DOH/DepEd’s standard health education Kato-Katz thick smear Control arm: Baseline Prevalence – 20.1% 1st FU – 16.4% 2nd FU -18.8% Intervention arm: Baseline Prevalence – 25.8% 1st FU – 19.7% 2nd FU – 21.3% Hürlimann et al. (2022) 25 Lao PDR Randomized controlled trial Nam Bak district in Luang Prabang Province Community-wide, aged six and 60 years Hookworms, Ascaris, Trichuris ABZ (400 mg) and IVM (200 µg/kg) ABZ (400 mg) qPCR Control arm: Trichuris : ERR – 69%, CR – 8% Ascaris : ERR – 100%c, CR – 100% Hookworms: ERR – 99%, CR – 56% Intervention arm: Trichuris : ERR – 99%, CR -66% Ascaris : ERR – 100%, CR – 100% Hookworms: ERR – 99%, CR – 59% Dyer et al. (2023) 36 Vietnam Randomized controlled trial Dak Lak Province Community-wide and school children Necator americanus ABZ (400 mg) to schoolchildren and the community-wide ABZ (400 mg) to schoolchildren only Multiplex qPCR Control arm: Baseline: Prevalence – 16.7% EPG – 1678.8 12 mos FU: Prevalence – 11.7% EPG – 1622.0 Intervention arm Baseline: Prevalence – 11.7% EPG – 1699.4 12 mos FU: Prevalence – 7.7% EPG – 747.7 Prevalence relative reduction: Control – 30.1% Intervention – 34.6% EPG relative reduction: Control – 3.4% Intervention – 56.0% Welsche et al. (2024) 37 Lao PDR Randomized controlled trial Nambak district, Luang Prabang Community-wide Trichuris ABZ (400 mg) and IVM (200 µg/kg) ABZ (400 mg) Kato-Katz thick smear Control arm: Arithmetic ERR – 0 to 64.1% Geometric ERR – 56.2% to 80.2%; Intervention arm: Arithmetic ERR – 91.9% to 97.2% Geometric ERR – 98.9% to 99.1% Nachaiwieng et al. (2024) 38 Thailand Quasi-experimental study Omkoi District, Chiang Mai Province Community-wide Ascaris and Trichuris ABZ (400 mg) with community health education ABZ (400 mg) Formalin ethyl acetate con centration method Control arm: Baseline prevalence: Ascaris – 0.6% Trichuris – 1.8% 3 mos FU prevalence: Ascaris – 0% Trichuris – 1.3% 6 mos FU prevalence Ascaris – 0% Trichuris – 0.5% Intervention arm: Baseline prevalence: Ascaris – 0.8% Trichuris – 5.4% 3 mos FU prevalence: Ascaris – 0% Trichuris – 4.8% 6 mos FU prevalence: Ascaris – 0.9% Trichuris – 6.4% ERR – Egg Reduction Rate; CR – Cure Rate; FU – Follow-up; EPG – Egg per gram; ABZ – Albendazole; MBZ – Mebendazole; IVM – Ivermectin; DEC – Diethylcarbamazine; PYR – Pyrantel pamoate Table 2 Results from cross-sectional studies included in this review. Reference and Year of Publication Country Location Population STH studied MDA history Test Used Key Outcomes Conlan et al. (2012) 39 Lao PDR Oudomxay, Luangprabang, Huaphan, and Xiengkhuang Provinces Community-wide, 6–11-year-old children, Women of childbearing age Ascaris; Trichuris; Hookworm; Strongyloides History of ABZ (400 mg) Formalin-ether concentration Any STH prevalence: 70.6% Ascaris prevalence: 26.1% Trichuris prevalence: 41.5% Hookworm prevalence: 46.3% Strongyloides prevalence: 8.9% Sanza et al. (2013) 40 Philippines Aklan, Antique, and Capiz Third-grade students (8–9 years old) Ascaris, Trichuris MBZ (500 mg) Kato-Katz thick smear Prevalence of STH moderate-to-heavy infection: statistically significant decrease from the baseline Effect on egg counts: decreased within the first follow-up but increased in the last follow-up. Belizario et al. (2016) 41 Philippines Municipalities of Aroroy, Cawayan, Milagros, and Monreal in Masbate Province Preschool-age children Hookworms, Ascaris, Trichuris 10 years history of MDA with ABZ (400 mg) or MBZ (500 mg) Kato-Katz thick smear STH prevalence: Ascaris - 59.0% Trichuris − 54.0% Hookworm − 2% Dunn et al. (2017) 42 Myanmar Udo village, Taikkyi township, Yangon Region and Kyee Kan Theik village, Nyaung Don township, Ayeyarwaddy Region Community-wide Hookworms, Ascaris, Trichuris ABZ (400 mg), DEC (6 mg/kg) Kato-Katz thick smear STH prevalence: Any STH − 27.81% Ascaris - 5.34% Trichuris − 18.12% Hookworm − 8.71% Ash et al. (2017) 43 Lao PDR Phongsaly Province Community-wide Hookworms, Ascaris, Trichuris 2 MDA with triple ABZ (400 mg) 5 months apart McMaster egg counting method; PCR species identification MDA1 STH Prevalence Reduction: Ascaris - 95.6% Trichuris − 69.2% Hookworm − 83.4% STH ERR: Ascaris - 99.4% Trichuris − 77.2% Hookworm − 94.4% MDA2 STH Prevalence Reduction: Ascaris - 93.5% Trichuris − 61% Hookworm − 84.5% STH ERR: Ascaris - 99.3% Trichuris − 88.5% Hookworm − 97.8% Staal et al. (2018) 44 Indonesia Nangapanda Village, Ende District, Flores Island School children Hookworms, Ascaris, Trichuris ABZ (400 mg) Kato-Katz thick smear Baseline STH prevalence: Ascaris - 8.4% Trichuris − 11.2% Hookworm − 4.9% FU STH prevalence Ascaris - 1.0% Trichuris − 3.9% Hookworm − 1.0% Vaz Nery et al. (2018) 45 Timor Leste Manufahi municipality Community-wide Necator and Ascaris ABZ (400 mg) Real-time multiplex PCR N. americanus CR − 58.3% Infection intensity reduction − 88.9% Ascaris CR − 91.4% Infection intensity reduction − 95.5% Sungkar et al. (2018) 46 Indonesia Perobatang Village, Southwest Sumba District Children aged 1–15 years Hookworms, Ascaris, Trichuris Tripple dose ABZ (400 mg) Kato-Katz thick smear Baseline STH prevalence: Ascaris - 65.4% Trichuris − 55.8% Hookworm − 15.4% FU STH prevalence: Ascaris - 8.3% Trichuris − 12.8% Hookworm − 0% Dunn et al. (2019) 47 Myanmar Udo village, Taikkyi township, Yangon Region and Kyee Kan Theik village, Nyaung Don township, Ayeyarwaddy Region Community-wide Hookworms, Ascaris, Trichuris Thrice administration of ABZ (400 mg) 4 and 6 mos apart Kato-Katz thick smear Baseline STH prevalence: Ascaris - 5.5% Trichuris − 17.02% Hookworm − 9.75% 1st FU STH prevalence: Ascaris - 1.72% Trichuris − 11.82% Hookworm − 6.69% 2nd FU STH prevalence: Ascaris - 2.49% Trichuris − 11.85% Hookworm − 5.54% Chai et al. (2020) 48 Myanmar South Dagon, North Dagon, and Hlaing-thar-yar of Yangon Region School children Hookworms, Ascaris, Trichuris ABZ (400 mg) Kato-Katz thick smear STH prevalence: Ascaris - 17.2% Trichuris − 19.4% Hookworm − 0.2% Stracke et al. (2021) 49 Thailand Mae Song subdistrict, Tha Song Yang district, Tak Province 2- to 6-year-old pre-school and school-aged children Ancylostoma ceylanicum, Ascaris, Trichuris History of annual MBZ (500 mg) administration multiplexed-tandem qPCR STH prevalence: Ascaris - 39.2% Trichuris − 36.6% A. ceylanicum − 1.1% Colella et al. (2021) 50 Cambodia Chambak Pa’em, Chamlong, Kam-pot, Rovieng Tboung, Sangker Roung, Pal Hal, Anglong Svay, Cham-long, Bos Pey and Sra’er Thom, Rovieng district, Preah Vihear Province Community-wide and animals Ancylostoma ceylanicum and Necator americanus ABZ (400 mg) multiplex qPCR Hookworm CR − 46.4% N. americanus CR − 48.3% A. ceylanicum CR − 52.6% Hookworms: Geometric ERR − 83.2% Arithmetic ERR − 72.5% N. americanus : Geometric ERR − 84.5% Arithmetic ERR − 77.6% A. ceylanicum : Geometric ERR − 98.7% Arithmetic ERR − 62.9% Hong et al. (2021) 51 Myanmar Shwe Pyi Thar, Twantay, and Kyauktan, Yangon Region Primary school-children Hookworms, Ascaris, Trichuris Nine rounds of ABZ (400 mg) Kato-Katz thick smear 1st FU prevalence: Ascaris − 23.3%; Trichuris − 23.3%; Hookworms − 0.1% 2nd FU prevalence: Ascaris − 17.3%; Trichuris − 26.2%; Hookworms − 0.8% 3rd FU prevalence: Ascaris − 17.3%; Trichuris − 27.4%; Hookworms − 0.3% 4th FU prevalence: Ascaris − 2.9%; Trichuris − 21.3%; Hookworms − 0% 5th FU prevalence: Ascaris − 7.2%; Trichuris − 14.5%; Hookworms − 0.2% 6th FU prevalence: Ascaris − 3.6%; Trichuris − 20.2%; Hookworms − 0.1% Tee et al. (2022) 52 Malaysia Rasau (Perak state), Sungai Judah, Tanjung Sepat and Bukit Bangkon, Selangor States Community-wide, aged four and 85 years Hookworms, Ascaris, Trichuris 3-day course of ABZ (400mg) Modified Kato-Katz technique 3 wk FU: Ascaris : CR − 100%, ERR − 100% Trichuris : CR − 64.6%, ERR − 94.2% Hookworm: CR − 100%, ERR − 100% 6 wk FU: Ascaris : no infection Trichuris : 25.8% prevalence, 250.2 EPG Hookworm: no infection Le et al. (2023) 27 Timor Leste Dili, Ermera, and Manufahi municipalities Schoolchildren Ascaris, Trichuris, N. americanus, Ancylostoma ceylanicum, An. duodenale IVM (200 µg/kg), DEC (6 mg/kg), and ABZ(400 mg) Multiplex qPCR Baseline prevalence: Ascaris − 18.1%, Trichuris − 4.8% N. americanus − 7.4% A. ceylanicum − 0.6% A. duodenale − 0.2% 18 mos FU prevalence: Ascaris − 13.2% Trichuris − 0.6% N. americanus − 5.9% A. ceylanicum − 3.4% A. duodenale − 0%. ERR – Egg Reduction Rate; CR – Cure Rate; FU – Follow-up; EPG – Egg per gram; ABZ – Albendazole; MBZ – Mebendazole; IVM – Ivermectin; DEC – Diethylcarbamazine 3.2. Benzimidazoles as the primary intervention Among the selected studies, BZ drugs, like ABZ (400 mg) and MBZ (500 mg), were the most used interventions in mass chemotherapy efforts (Fig. 2 D). Indeed, MDA with BZ monotherapy remains the cornerstone of control and elimination efforts against STH infections. 18 , 19 This is particularly true in other endemic regions like South America 53 , 54 , South Asia 55 and Africa 56 , 57 . Several SEA nations recognized the serious threat of STH infections early and established control programs: Malaysia in 1974, Indonesia in 1975, Thailand in 1980, and the Philippines in 1999. 6 Likewise, school-based deworming efforts were initiated in Vietnam, Lao PDR, and Myanmar with aid from foreign agencies and support from affluent countries. 6 Some of these programs were discontinued due to lack of funding or were reliant on donations, loans, and support from foreign agencies for the drugs needed for mass PC. 6 At the turn of the millennium, renewed enthusiasm for MDA against STH infections was seen. For instance, a 95% MDA coverage was reported during a country-wide, school-based deworming program that was conducted in Lao PDR in 2006. 58 Likewise, the high infection prevalence reported previously prompted the Philippine government to implement the Integrated Helminth Control Program in 2006, which is still ongoing. 7 , 11 , 19 , 59 Similar efforts were implemented in Indonesia through governmental programs and in Cambodia through foreign support. 60 Several cross-sectional studies included in this review assessed the effects of BZ monotherapy on infection prevalence. For instance, Sanza et al. 40 reported a significant drop in STH prevalence in several provinces in central Philippines that have received several rounds of Mebendazole monotherapy. Similarly, a preliminary study by Staal et al. 44 in Indonesia reported a decrease in A. lumbricoides, T. trichiura , and hookworm infection prevalence at follow-up post ABZ treatment. Monotherapy and combination therapy studies also reported the effects of the cure rates (CR) and egg reduction rates (ERR). An early trial by Soukhathammavong et al. 30 observed that subpar CR (less than 95%) against A. lumbricoides but had superior ERR at 100%. Disappointing CRs and ERRs were found among hookworms and T. trichiura. A similar trend was observed by Levecke et al. 31 in trials conducted in Vietnam and Cambodia and by Vaz Nery et al. 45 in Timor Leste among school-aged children. A communitywide study by Ash et al. 43 in Lao PDR found that two rounds of triple-dose ABZ significantly reduced the prevalence of A. lumbricoides and hookworm infections, and the treatment had superior ERR in these helminths. Both prevalence reduction and ERR in T. trichiura were lowered. 43 Communitywide treatment with ABZ, as observed by Dyer et al. 36 , caused a better prevalence and intensity of infection reductions when compared to only giving treatment to schoolchildren in Vietnam. The use of BZ drugs for the control and elimination of STH infections relies on their efficacy, as proven in the cited studies above, their safety, and ease of administration. 21 The challenge, however, is varied efficacies among the different STH species. 61 Hence, its combination with other dewormers from different classes has been explored. 3.3. Combination therapy: the new frontier? Studies that assessed the effect of combination therapy against STH infections also reported varying outcomes. Sapulete et al. 26 assessed the efficacy of combining PYR and ABZ in comparison to ABZ treatment alone in school children from Indonesia. The addition of PYR treatment increased the CR by 20%. 26 Another trial by Keller et al 34 that utilized the IVM + ABZ versus ABZ monotherapy observed that those receiving the combination treatment showed superior ERR at 2 to 3 weeks, 6 months, and 1 year after the treatment. Utilizing qPCR as their diagnostic tool, Hürlimann et al. 25 reported that the ABZ + IVM treatment had superior A. lumbricoides, T. trichiura , and hookworm CRs and ERRs compared to ABZ monotherapy. The addition of DEC, IVM, and ABZ resulted in reduced infection prevalence of several hookworm species. 27 Other reports from other regions affirm the enhanced efficacy when BZs are combined with IVM. A recent meta-analysis showed enhanced prevalence reduction when ABZ + IVM was used against T. trichiura infections compared to IVM alone: 89.40% vs. 49.93%, respectively. 62 Against strongyloidiasis, however, IVM (84.49%) alone was slightly better in reducing infection prevalence than ABZ + IVM (81.37%). 62 In India, ABZ + IVM was also shown to increase the ERR of A. lumbricoides when compared to ABZ monotherapy: 93.22% vs. 90.61%, respectively. 63 A cross-sectional study in a population receiving concurrent ABZ + IVM mass treatment in Cameroon found that the drug combination could have collateral impacts that can hasten control and elimination of STH. 64 Moreover, ABZ + IVM’s efficacy in reducing the incidence of STH-associated anemia and infections, and their relative safety during pregnancy was assessed in Uganda. 65 The results of the included studies in our review and those from the literature indicate that adding drugs from different classes to BZs improved the efficacy of treatments across a variety of STH species that affect populations within endemic areas. This point was highlighted by Emerson et al. 66 when they pointed out that combination therapy with appropriate drugs targeted toward the most susceptible helminth species can hasten the achievement of global control and elimination targets and therefore lessen the risk of resistance development. 3.4. PC with Health Education and WASH initiatives: the ol’ reliables The combination of non-pharmaceutical interventions with drug-based treatments also showed promising effects on STH infections. The ‘Fit for School’ program, which included daily handwashing with soap, daily brushing with fluoride toothpaste, and biannual deworming with ABZ, resulted in reduced prevalence of STH infections of moderate to heavy intensity. 29 Another innovation in health education was the incorporation of Magic Glasses, which is a health education intervention aimed at preventing intestinal worms in schoolchildren that involves using engaging cartoon videos and educational materials. 67 The trial done by Mationg et al. 35 in the Philippines showed that the integration of the Magic Glasses program into the biannual ABZ administration program resulted in insignificant changes in the infection prevalence but markedly improved the knowledge and behavior of the schoolchildren receiving the intervention. Aside from health education, the provision of WASH infrastructure with deworming also improved infection control. A preliminary study showed that the provision of latrines and health education, together with ABZ treatment, significantly decreased the STH infection prevalence in schoolchildren in Indonesia. 32 These results show the value of incorporating health education and WASH initiatives with drug administration for the control and elimination of STH infections. Recently, Mationg et al. 67 conducted a review of studies that assessed the effectiveness of health education packages against STH and their impacts on infection control. They found only three studies, highlighting the neglect of this intervention in the current drug-based paradigm. As the included papers in our review purport, health education plays a crucial role in improving the knowledge and attitudes of the target populations. Likewise, improving WASH facilities enables the elimination of open defecation and improves hygiene practices that result in STH infection prevention and avert reinfection. 68 A multi-pronged approach that includes health education and WASH facility provision with mass treatment can facilitate faster achievement of control and elimination targets. 3.5. Indications of diminished efficacy Several alarming reports of reduced mass treatment efficacies, in comparison to the guidelines set by the WHO 61 , were documented by some of the included studies. The WHO guideline stipulates that an anthelmintic drug's effectiveness is categorized as "satisfactory" if its ERR meets or exceeds the reference value, and as "doubtful" or "reduced" if the ERR falls below the reference value by less or more than 10 percentage points, respectively. 61 The aforementioned study comparing the efficacy of ABZ and MBZ in Lao PDR reported doubtful ERR (i.e., less 10 percentage points less than the 90% satisfactory value) among hookworms when the former was administered. 30 More recently, Colella et al. 50 used qPCR to assess the efficacy of ABZ treatment and showed diminished efficacy because ERRs of hookworm infections in Cambodia were reduced (i.e., more than 10 percentage points less than the 90% satisfactory value). A similar trend was also observed in Timor-Leste, where ABZ treatment did not result in ERRs for N. americanus that were within satisfactory levels. 45 Persistent prevalence despite the histories of repeated treatments was also reported. A history of BZ treatment in schoolchildren and women of reproductive age failed to cut the prevalence of A. lumbricoides, T. trichiura , and hookworms in northern Lao PDR where it remained relatively high. 39 In Myanmar, six rounds of ABZ treatment failed to consistently bring down the prevalence of T. trichiura infections. 51 A decade of MDA with BZ drugs in schoolchildren in the Philippines also failed to reduce the STH infection prevalence—more than 50% in A. lumbricoides and T. trichiura —to reach the national and global control targets. 41 Reduced ABZ efficacy against A. lumbricoides and T. trichiura has also been reported in Gabon 69 and Ethiopia 70 . These results indicate that mass treatments with BZs may have reduced efficacy depending on the species of the helminth and the drug used. This issue provides an opportunity for combination therapy regimens that can enhance efficacy, as proven by the studies mentioned in the previous section. The long-term consequences of combination treatment against STH have yet to be fully assessed. However, the emergence of multidrug-resistant STH has been raised as a concern as a consequence of combination therapy. 71 – 73 Likewise, evidence of multidrug-resistant animal hookworms due to protracted use of combination therapy in the United States and Canada should also be kept in mind. 74 – 76 The role of other factors (i.e., treatment coverage and compliance) needs to be thoroughly evaluated in all endemic countries in SEA. Moreover, the indication of resistance has yet to be fully elucidated by field data in this region. Guidelines on the determination of resistance in STH have yet to be promulgated. 77 Only guidelines for the assessment of PC efficacy against STH and schistosomiasis have been established by the WHO. 61 Our comprehensive review has some limitations. First, we were not able to incorporate data from governmental databases due to the focus on peer-reviewed literature only. Some PC efforts may not be described in peer-reviewed literature. However, through extensive searches and sufficient selection and eligibility criteria, we were able to include studies that were done in areas where government-implemented MDA was being done, such as those in the Philippines 35 , 41 and Lao PDR 39 . Secondly, the variability in the sample sizes, control groups used (if necessary), outcomes measured, and study designs hamper the integrated analysis of the data from the included studies. Despite these issues, our utilization of appropriate risk-of-bias tools allowed for the assessment of each study's quality, confirming that the included results and their synthesis were of acceptable scientific merit. 4. Conclusion This comprehensive review aimed to update knowledge on mass treatment for STH control in SEA countries by collecting and synthesizing peer-reviewed literature. We searched several databases and included 27 studies that passed our screening and eligibility criteria. These papers were of different study designs and utilized various drug interventions. BZ drugs, like ABZ and MBZ, remained the most used anthelmintic in mass deworming efforts in the region with often satisfactory but inconsistent results in terms of efficacy and reducing infection prevalence. An emerging trend that the papers reported on is the combination of anthelmintics from different classes with BZs to enhance efficacy. Moreover, comprehensive efforts that include health education and WASH facility improvement with deworming result in enhanced infection reduction. Several reports have documented diminished efficacies—insufficient ERRs and failure to significantly reduce infection prevalence—when BZs are used against hookworms and T. trichiura infections. Combination therapy (e.g., ABZ + IVM) provides an opportunity to address this issue and enhance efficacy. Therefore, judicious combination therapy with health education packages and improvement of WASH can hasten the achievement of control and elimination targets and abate the threat of resistance. Abbreviations STH Soil-transmitted helminths WHO World Health Organization WASH Water, sanitation and hygiene SEA Southeast Asia MDA Mass Drug Administration ASEAN Association of Southeast Asian Nations PC Preventive Chemotherapy BZ Benzimidazole ABZ Albendazole MBZ Mebendazole IVM Ivermectin DEC Diethylcarbamazine PYR Pyrantel pamoate CR Cure Rate ERR Egg Reduction Rate PCR Polymerase Chain Reaction Declarations Supplementary Materials Supplementary tables and figures are available at [DOI] Acknowledgements JCBT and AK would like to acknowledge the Postgraduate Scholarship for International Students of the Faculty of Medicine, Khon Kaen University for funding their doctoral studies. Also, MFH acknowledges Khon Kaen University Active Recruitment Scholarships for funding his master’s degree studies. SS is supported by the Fundamental Fund of Khon Kaen University and the National Science, Research, and Innovation Fund. Author Contributions JCBT : Conceptualization; Writing -Original Draft; Methodology; Formal Analysis. MFH : Methodology; Writing – Editing and Reviewing. AK: Methodology; Writing – Editing and Reviewing. SS and PS: Conceptualization; Writing – Editing and Reviewing; Supervision. Data Availability Due to the nature of this research, data was not generated. All information used for analysis is provided herein and in the supplementary materials. Competing Interest The authors have no competing interests to declare. Funding This research did not receive any funding. Ethics Statements Ethics clearance is not required due to the nature of the study. Consent for Publication Not applicable due to the nature of the study. Declaration of Generative AI in the Writing Process Large language models were not used to generate text for this review. Clinical Trial Registration Not applicable due to the nature of the study. 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Infect Dis Poverty 13:8. 10.1186/s40249-024-01176-6 Ng’etich AI, Amoah ID, Bux F, Kumari S (2023) Anthelmintic resistance in soil-transmitted helminths: One-Health considerations. Parasitol Res 123(1):62. 10.1007/s00436-023-08088-8 Tenorio JC (2024) Drug resistance in parasites: A review of mechanisms, drivers, and mitigation strategies. Microbes Infect Dis 0(0):0–0. 10.21608/mid.2024.317774.2189 Tinkler SH (2020) Preventive chemotherapy and anthelmintic resistance of soil-transmitted helminths – Can we learn nothing from veterinary medicine? One Health 9:100106. 10.1016/j.onehlt.2019.100106 Jimenez Castro PD, Howell SB, Schaefer JJ, Avramenko RW, Gilleard JS, Kaplan RM (2019) Multiple drug resistance in the canine hookworm Ancylostoma caninum: an emerging threat? Parasites Vectors 12(1):576. 10.1186/s13071-019-3828-6 Tenorio JCB, Heikal MF, Kafle A, Saichua P, Suttiprapa S (2024) Benzimidazole Resistance-Associated Mutations in the β-tubulin Gene of Hookworms: A Systematic Review. Parasitol Res 123(12):405. 10.1007/s00436-024-08432-6 Venkatesan A, Castro PDJ, Morosetti A et al (2023) Molecular evidence of widespread benzimidazole drug resistance in Ancylostoma caninum from domestic dogs throughout the USA and discovery of a novel β-tubulin benzimidazole resistance mutation. PLoS Pathog 19(3):e1011146. 10.1371/journal.ppat.1011146 Freeman MC, Akogun O, Belizario V et al (2019) Challenges and opportunities for control and elimination of soil-transmitted helminth infection beyond 2020. Webster JP, ed. PLoS Negl Trop Dis . ;13(4):e0007201. 10.1371/journal.pntd.0007201 Additional Declarations The authors declare no competing interests. Supplementary Files SuppmelentaryMaterials.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7089344","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Systematic Review","associatedPublications":[],"authors":[{"id":483302322,"identity":"ae5f2854-37d5-4515-a94e-0967a09fa4ec","order_by":0,"name":"Jan Clyden Tenorio","email":"","orcid":"","institution":"University of Southern Mindanao","correspondingAuthor":false,"prefix":"","firstName":"Jan","middleName":"Clyden","lastName":"Tenorio","suffix":""},{"id":483302323,"identity":"efa711b9-e3fb-4b24-a2b2-1aa627485da9","order_by":1,"name":"Alok Kafle","email":"","orcid":"","institution":"Khon Kaen 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04:00:40","extension":"html","order_by":8,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":220977,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7089344/v1/1af8edc048b40237600b458e.html"},{"id":93897628,"identity":"1562847e-7b5e-4065-8493-2e9ee2cb1bf7","added_by":"auto","created_at":"2025-10-20 04:00:39","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":687860,"visible":true,"origin":"","legend":"\u003cp\u003ePRISMA summary of the systematic literature search, screening, and selection done in this review\u003c/p\u003e","description":"","filename":"Figure1.PRISMAFlowchart.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7089344/v1/92c9a8eefd8d9157ad8019fa.jpg"},{"id":93897631,"identity":"51ff89e1-e1c8-41b5-a9e2-0751f2dd69a9","added_by":"auto","created_at":"2025-10-20 04:00:39","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":764444,"visible":true,"origin":"","legend":"\u003cp\u003eKey characteristics of the included studies in this review. A: All but two countries in SEA were represented in the included studies. B: Most of the studies conducted community-based MDA. C: The studies included were of three types: randomized controlled trials, quasi-experimental studies, and cross-sectional studies. D: \u003cem\u003eTrichuris, Ascaris, \u003c/em\u003eand hookworms were all represented in the studies included.\u003c/p\u003e","description":"","filename":"Figure2.Data.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7089344/v1/fe72b356d7cf18d312126188.jpg"},{"id":93898743,"identity":"bf5811f0-c3bc-4b14-9e95-4a76a57008dd","added_by":"auto","created_at":"2025-10-20 04:16:41","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2974936,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7089344/v1/c4e8dbdf-8818-45cd-a53b-4ea895956f33.pdf"},{"id":93897630,"identity":"d01c9630-bc8c-4a1a-8162-abd42e118d9e","added_by":"auto","created_at":"2025-10-20 04:00:39","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":142460,"visible":true,"origin":"","legend":"","description":"","filename":"SuppmelentaryMaterials.docx","url":"https://assets-eu.researchsquare.com/files/rs-7089344/v1/a70a14485a47769893a0bc69.docx"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eA systematic review of preventive chemotherapy against soil-transmitted helminth infections in Southeast Asia: Combination therapy, enhanced WASH, and integrated health education to accelerate control\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eSoil-transmitted helminth (STH) infections remain a significant threat to public health in endemic areas in tropical and subtropical climates.\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e The World Health Organization (WHO) estimates that around 1.5\u0026nbsp;billion people are affected, approximately a quarter of the global population.\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e Recent data from the 2021 Global Burden of Disease study indicate that there are approximately 642\u0026nbsp;million cases worldwide, which account for 1.38\u0026nbsp;million DALYs (disability-adjusted life-years).\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e The age-standardized prevalence is 8429.89 per 100,000 population, representing a 70% drop from the 1990 data.\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e These infections are caused by \u003cem\u003eAscaris lumbricoides, Trichuris trichiura\u003c/em\u003e, hookworm species like \u003cem\u003eNecator americanus\u003c/em\u003e and \u003cem\u003eAncylostoma duodenale\u003c/em\u003e, and \u003cem\u003eStrongyloides stercoralis.\u003c/em\u003e\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e \u003cem\u003eAncylostoma ceylanicum\u003c/em\u003e is a zoonotic hookworm that affects companion animals and humans in the Asia-Pacific region \u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e. Southeast Asia (SEA) is a hotspot for STH infections, accounting for one-third of all reported cases globally.\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e A 2008 WHO report documented that STH infection prevalence exceeded 50% in some areas of Cambodia, Indonesia, Myanmar, the Philippines, and Vietnam.\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e A 2018 systematic review found that the prevalence of \u003cem\u003eA. lumbricoides\u003c/em\u003e exceeded 20% in Myanmar, the Philippines, Malaysia, and Indonesia, while hookworm infections surpassed this threshold in those countries plus Cambodia.\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e Also, a recent analysis indicates that \u003cem\u003eT. trichiura\u003c/em\u003e affects over 685\u0026nbsp;million people in SEA, with a pooled prevalence of 20.95%.\u003csup\u003e9\u003c/sup\u003e The latest Philippine national survey showed STH infection prevalence 8% above the 20% national target, and moderate-to-heavy infections over 30% above the 2% target.\u003csup\u003e10,11\u003c/sup\u003e Recent studies in Myanmar and Vietnam, using qPCR and Kato-Katz smears, respectively, revealed alarmingly high rates of STH infections in schoolchildren, with 78.8% infected in Myanmar (predominantly \u003cem\u003eA. lumbricoides\u003c/em\u003e and \u003cem\u003eT. trichiura\u003c/em\u003e) and 76.1% in Vietnam.\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e,\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e In Malaysia and Thailand, persistently high STH infections in indigent and tribal communities remain a significant health problem, especially among children living in these remote and rural areas.\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e,\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e STH infections have had a shared history with the countries in SEA. Hence, it is not surprising that various efforts to control these parasitic health threats have been implemented across the region.\u003c/p\u003e\u003cp\u003eSTH infections pose a significant health threat to vulnerable segments of the population within endemic regions, particularly schoolchildren, women of reproductive age, and immunocompromised individuals.\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e,\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e Among children, pathologic consequences of infection include iron-deficiency anemia, stunting, malnutrition, cognitive development issues, and motor deficits.\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e,\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e,\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e The severe effects of high-burden infections among schoolchildren led to efforts towards control, elimination, and prevention of STH infections in this vulnerable population.\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e The cornerstone of these efforts has been Preventive Chemotherapy (PC) with Benzimidazole (BZ) drugs through Mass Drug Administration (MDA) programs.\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e,\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e Control and elimination efforts against STH aim to reduce infection prevalence, lower pathologic consequences of infections, and prevent reinfection.\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e,\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e,\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e Nearly 900\u0026nbsp;million pre- and school-aged children around the world require PC against STH infections based on 2023 WHO data. \u003csup\u003e22\u003c/sup\u003e The 2018 WHO data showed that several endemic SEA countries had varying levels of PC coverage: Indonesia did not reach 75%, the Philippines and Vietnam achieved over 75% but for less than five years, and only Cambodia, Lao PDR, and Myanmar sustained coverage above 75% for more than five years.\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e Among the same countries, the 2023 WHO data on PC coverage in pre- and school-aged children showed that only Indonesia, Myanmar, Cambodia, and Vietnam achieved the target 75% benchmark.\u003csup\u003e22\u003c/sup\u003e Meanwhile, the Philippines at 29.73% and Lao PDR at 57.05% lagged behind.\u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e SEA nations have demonstrated a sustained commitment to combating STH infections through various control programs and MDA initiatives. Significant disparities in coverage and long-term success highlight the ongoing challenges of achieving consistent and equitable elimination across the region.\u003c/p\u003e\u003cp\u003eThe fight against STH infections remains a difficult and ongoing process in endemic SEA countries. Trends and developments in these control and elimination efforts need to be assessed to forge the most appropriate path towards achieving national and global elimination targets.\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e,\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e,\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e Hence, the objective of this comprehensive review is to provide an update on drug-based control and elimination efforts for the control and elimination of STH infections in SEA by summarizing and analyzing findings from peer-reviewed research. Here, we analyzed research published between 2011 and 2025 to document trends in PC using mono- and combination drug administration, presented the value of integrated control efforts that include health education and WASH, and highlighted research indicating diminished efficacy of MDA efforts from many countries of the region.\u003c/p\u003e"},{"header":"2. Materials and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e2.1. Research Questions\u003c/h2\u003e\u003cp\u003eThis systematic review aimed at answering the following research questions:\u003c/p\u003e\u003cp\u003e\u003col\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eWhich SEA countries have implemented drug-based STH control efforts, as reported in peer-reviewed literature published from 2011 to 2025\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eWhat drugs have been used as interventions in these control efforts?\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eWhat were the treatment outcomes of drug administration in controlling infections in these countries?\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\u003ch2\u003e2.2.Search Strategy\u003c/h2\u003e\u003cp\u003eSix databases were searched in this systematic review. Medline via PubMed (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e), Scopus (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.scopus.com/sources\u003c/span\u003e\u003cspan address=\"https://www.scopus.com/sources\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e), Science Direct (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.sciencedirect.com/search/entry\u003c/span\u003e\u003cspan address=\"https://www.sciencedirect.com/search/entry\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e), EBSCO Host (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://search.ebscohost.com/\u003c/span\u003e\u003cspan address=\"https://search.ebscohost.com/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e), and ProQuest (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.proquest.com/\u003c/span\u003e\u003cspan address=\"https://www.proquest.com/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e) were searched for literature [Accessed 7 to 11 February 2025]. All database searches were restricted to the publication date from January 2011 to January 2025. This time restriction was chosen to provide a follow-up to the review on the same topic by Jex et al.\u003csup\u003e6\u003c/sup\u003e This review is limited to the member countries of the Association of Southeast Asian Nations (ASEAN). For EBSCO Host, the Applied Science and Technology Source Ultimate, CINAHL Complete, MEDLINE, and Newswires databases were selected. The specific terms used to search the databases can be found in Supplementary Table\u0026nbsp;1. The .ris and .nbib files of the searches were downloaded.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003e2.3. Study Screening, Selection, and Eligibility\u003c/h2\u003e\u003cp\u003eThe search results were uploaded to Rayyan (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.rayyan.ai/\u003c/span\u003e\u003cspan address=\"https://www.rayyan.ai/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e), where study selection, screening, and eligibility checking were done [Accessed 14 to 21 February 2025]. Rayyan is an AI-assisted platform for streamlining study screening, provides a robust collaboration tool, and the ability to import and deduplicate references from various sources \u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e. The platform was used for duplicate detection, with 95% text similarity as the resolution limit. Duplicates with \u0026lt;\u0026thinsp;95% similarity were resolved manually. The titles and abstracts were used for the initial screening, and papers lacking these components were excluded. The detailed inclusion and exclusion criteria used for assessment are mentioned in Supplementary Table\u0026nbsp;2. The first, second, and third authors conducted the study selection, screening, and eligibility, and all authors collaboratively resolved disagreements to reach a consensus. Figure\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e provides an overview of this review's study selection, screening, and eligibility process.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003e2.3. Risk of bias assessment, data extraction, and synthesis\u003c/h2\u003e\u003cp\u003eThe papers that passed the eligibility assessments were of several types: cross-sectional and quasi-experimental studies, and randomized controlled trials. Due to this diversity of study types, several risk-of-bias tools were utilized. The Joanna Briggs Institute\u0026rsquo;s Critical Appraisal Checklist for Analytical Cross-Sectional Studies, Critical Appraisal Checklist for Quasi-Experimental Studies, and Critical Appraisal Tool For Assessment of Risk of Bias for Randomized Controlled Trials were used (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://jbi.global/critical-appraisal-tools\u003c/span\u003e\u003cspan address=\"https://jbi.global/critical-appraisal-tools\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e). The second and third authors independently reviewed the risk of bias assessment. The fourth and fifth authors resolved disagreements. The results of the risk of bias assessment are provided in Supplementary Figs.\u0026nbsp;1\u0026ndash;3.\u003c/p\u003e\u003cp\u003eThe included papers were given codes (Supplementary Table\u0026nbsp;3). Several data were extracted from the included studies. These include authors\u0026rsquo; names, year of publication, title, type of study, specific locale and country of the study, population, STH species studied, drug-based intervention, comparison groups (if any), test used, and their key outcomes. These were input into a spreadsheet. The study results were described, summarized, and synthesized using descriptive statistics, specifically counts and percentages.\u003c/p\u003e\u003c/div\u003e"},{"header":"3. Results and Discussion","content":"\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003e3.1. Characteristics of the studies included\u003c/h2\u003e\u003cp\u003eSix databases were searched, and a total of 4294 hits were retrieved (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Of these, 67% were removed due to duplication. The initial screening of 1244 articles resulted in a 97% removal rate, with exclusions based on publication type (reviews and abstracts), study location (outside SEA), pathogen focus, publication date (outside January 2011 to January 2025), incomplete metadata (no authors/abstract), and language (non-English). Eligibility screening was conducted on the full text of the remaining 41 papers. 34% of these were excluded due to having the wrong study design and outcome. 27 papers were included in the study, and all of them passed the risk of bias assessment (Supplementary Figs.\u0026nbsp;1\u0026ndash;3).\u003c/p\u003e\u003cp\u003eThe included studies span all the countries of SEA, except Brunei Darussalam and Singapore, where PC is not required \u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eA). Lao PDR had the highest number of studies with six, followed by Myanmar, Indonesia, and the Philippines with four. Three studies were conducted in Timor-Leste, while two studies each were done in Thailand, Cambodia, and Vietnam. Malaysia was represented by one study. Of these countries, Thailand and Malaysia do not require PC.\u003csup\u003e22\u003c/sup\u003eStudies were done both in schoolchildren (i.e., pre- and school-aged) and community folks. Among the STH studied, the most represented was \u003cem\u003eT. trichiura\u003c/em\u003e, followed by \u003cem\u003eA. lumbricoides\u003c/em\u003e and hookworms. Most of the studies included in this review were analytical cross-sectional studies, followed by randomized control trials with quasi-experimental studies being the least represented.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eBZ drugs, particularly Albendazole (400 mg) (ABZ) and Mebendazole (500 mg) (MBZ), were the most frequently employed interventions for MDA in the included studies. Combination therapy, where drugs from different classes of anthelmintic are combined to expand the range of activity and increase efficacy, has also been an emerging trend in the included studies. BZ drugs were combined with Macrocyclic lactones like Ivermectin (IVM) \u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e and Pyrimidine derivatives like Pyrantel pamoate (PYR).\u003csup\u003e\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u003c/sup\u003e Likewise, the combination of drugs to integrate the control of numerous parasitic helminths of public health importance was also reported. For instance, the combination of ABZ, IVM, and diethylcarbamazine (DEC) against lymphatic filariasis, scabies, and STH has been trialed regarding its effect on infection prevalence reduction.\u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e Comprehensive control efforts that integrate drug-based interventions with health education, provision of clean water, and improvement of sanitation and hygiene standards have also been reported by the studies included.\u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e,\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e The effects of these interventions are provided in the following section. Key information regarding the included studies is summarized in Tables\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e and \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eKey results from randomized controlled trials and quasi-experimental studies included in this review.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"10\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eReference and Year of Publication\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCountry\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eStudy Design\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eLocation\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePopulation\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eSTH studied\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eMDA Interventions (Dose)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eComparison group\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003eTest Used\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u003cp\u003eKey Outcomes\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSoukhathammavong et al. (2012) \u003csup\u003e\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLao PDR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRandomized controlled trial\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eBatieng district, Champasak Province\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eChildren aged 6\u0026ndash;12 years old\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eHookworms, \u003cem\u003eAscaris, Trichuris\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eABZ (400 mg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eMBZ (500 mg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eKato-Katz thick smear\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003eHookworms:\u003c/p\u003e\u003cp\u003eABZ CR-32.0%\u003c/p\u003e\u003cp\u003eABZ ERR-86.7%\u003c/p\u003e\u003cp\u003eMBZ CR-15%\u003c/p\u003e\u003cp\u003eMBZ ERR-76.3%\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e:\u003c/p\u003e\u003cp\u003eABZ CR-92.9%\u003c/p\u003e\u003cp\u003eABZ ERR-100%\u003c/p\u003e\u003cp\u003eMBZ CR-93.3%\u003c/p\u003e\u003cp\u003eMBZ ERR-100%\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e:\u003c/p\u003e\u003cp\u003eABZ CR-33.3%\u003c/p\u003e\u003cp\u003eABZ ERR-67%\u003c/p\u003e\u003cp\u003eMBZ CR-27.9%\u003c/p\u003e\u003cp\u003eMBZ ERR-66%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMonse et al. (2013) \u003csup\u003e\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePhilippines\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eQuasi-experimental study\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eCamiguin and Misamos Oriental Provinces\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eFirst-grade students (6\u0026ndash;7 years old) of public elementary schools\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eSTH (taken together)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eABZ (400 mg), daily supervised brushing with a fluoride toothpaste\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eExternal concurrent control groups and Internal non-concurrent control groups\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eKato-Katz thick smear\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003eIntervention arm: 10.7% reduction in the prevalence of STH moderate-to-heavy infection\u003c/p\u003e\u003cp\u003eControl arm: 12.4% reduction in the prevalence of STH moderate-to-heavy infection\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLevecke et al. (2014) \u003csup\u003e\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCambodia and Vietnam\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRandomized controlled trial\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eCambodia and Vietnam\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eSchoolchildren aged 4\u0026ndash;18 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eHookworms, \u003cem\u003eAscaris, Trichuris\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eMBZ (500 mg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eABZ (400 mg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eMcMaster egg counting method\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e:\u003c/p\u003e\u003cp\u003eABZ \u0026ndash; 100% FECR in Vietnam\u003c/p\u003e\u003cp\u003eBZ \u0026ndash; 93.9% FECR in Vietnam\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e:\u003c/p\u003e\u003cp\u003eABZ \u0026ndash; 92.3% FECR in Vietnam\u003c/p\u003e\u003cp\u003eMBZ \u0026ndash; 76.8% FECR in Vietnam\u003c/p\u003e\u003cp\u003eHookworms:\u003c/p\u003e\u003cp\u003eABZ \u0026ndash; 97.6% FECR in Cambodia\u003c/p\u003e\u003cp\u003eMBZ \u0026ndash; 79.7% FECR in Cambodia\u003c/p\u003e\u003cp\u003eABZ \u0026ndash; 100% FECR in Vietnam\u003c/p\u003e\u003cp\u003eMBZ \u0026ndash; 95% FECR in Vietnam\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePark et al. (2016) \u003csup\u003e\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIndonesia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eQuasi-experimental study\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eGunungpati sub-district, Semarang, Central Java\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eChildren between the ages of 3 and 13\u0026nbsp;years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eSTH (taken together)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eABZ (400 mg), BALatrines\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eNo intervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eSodium nitrate fecal floatation technique\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003eSTH prevalence:\u003c/p\u003e\u003cp\u003eControl arm \u0026ndash; 20.4%\u003c/p\u003e\u003cp\u003eIntervention arm \u0026ndash; 4%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eClarke et al. (2018) \u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTimor Leste\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRandomized controlled trial\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eAileu and Manufahi municipalities\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCommunity-wide and school children\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eHookworms, \u003cem\u003eAscaris, Trichuris\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eCommunity-wide ABZ (400 mg) MDA and WASH\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eABZ (400 mg) MDA and WASH only in schools\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eReal-time multiplex PCR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003eControl Arm Prevalence:\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e - 48.7%\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e \u0026ndash; 2.2%\u003c/p\u003e\u003cp\u003e\u003cem\u003eN. americanus\u003c/em\u003e- 13.7%\u003c/p\u003e\u003cp\u003eIntervention Arm Prevalence:\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e - 7.6%\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e \u0026ndash; 1.9%\u003c/p\u003e\u003cp\u003e\u003cem\u003eN. americanus\u003c/em\u003e \u0026ndash; 15.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eSapulete et al. (2020)\u003c/span\u003e \u003csup\u003e\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIndonesia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRandomized controlled trial\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eBangli, Bali\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e8\u0026ndash;12 years old children\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eABZ(400 mg) and PYR (10 mg/kg ) for 3 consecutive days\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eABZ(400 mg) for 3 consecutive days\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eKato-Katz thick smear\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003eControl arm CR: 40%\u003c/p\u003e\u003cp\u003eIntervention arm CR: 60%\u003c/p\u003e\u003cp\u003eControl arm % Satisfactory ERR (\u0026ge;\u0026thinsp;50%): 44.7%\u003c/p\u003e\u003cp\u003eIntervention arm % Satisfactory ERR (\u0026ge;\u0026thinsp;50%): 55.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eKeller et al. (2021) \u003csup\u003e\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLao PDR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRandomized controlled trial\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNam Bak district in Luang Prabang Province\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCommunity-wide, aged six to 60 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eHookworms, \u003cem\u003eAscaris, Trichuris\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eABZ (400 mg) and IVM\u003c/p\u003e\u003cp\u003e (200 \u0026micro;g/kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eABZ (400 mg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eKato-Katz thick smear\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e14 to 21 days ERR:\u003c/p\u003e\u003cp\u003eControl arm \u0026ndash; 68.8%\u003c/p\u003e\u003cp\u003eIntervention arm \u0026ndash; 99.2%\u003c/p\u003e\u003cp\u003e6 mos ERR:\u003c/p\u003e\u003cp\u003eControl arm \u0026ndash; 79.6%\u003c/p\u003e\u003cp\u003eIntervention arm \u0026ndash; 99%\u003c/p\u003e\u003cp\u003e12 mos ERR:\u003c/p\u003e\u003cp\u003eControl arm \u0026ndash; 91.3%\u003c/p\u003e\u003cp\u003eIntervention arm \u0026ndash; 99.6%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMationg et al. (2022) \u003csup\u003e\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePhilippines\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRandomized controlled trial\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eLaguna Province\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eSchoolchildren aged 9\u0026ndash;10 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eAny STH\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eABZ (400 mg) MDA with Magic Glasses\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eABZ (400 mg) MDA with DOH/DepEd\u0026rsquo;s standard health education\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eKato-Katz thick smear\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003eControl arm:\u003c/p\u003e\u003cp\u003eBaseline Prevalence \u0026ndash; 20.1%\u003c/p\u003e\u003cp\u003e1st FU \u0026ndash; 16.4%\u003c/p\u003e\u003cp\u003e2nd FU -18.8%\u003c/p\u003e\u003cp\u003eIntervention arm:\u003c/p\u003e\u003cp\u003eBaseline Prevalence \u0026ndash; 25.8%\u003c/p\u003e\u003cp\u003e1st FU \u0026ndash; 19.7%\u003c/p\u003e\u003cp\u003e2nd FU \u0026ndash; 21.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eH\u0026uuml;rlimann et al. (2022) \u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLao PDR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRandomized controlled trial\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNam Bak district in Luang Prabang Province\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCommunity-wide, aged six and 60 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eHookworms, \u003cem\u003eAscaris, Trichuris\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eABZ (400 mg) and IVM\u003c/p\u003e\u003cp\u003e (200 \u0026micro;g/kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eABZ (400 mg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eqPCR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003eControl arm:\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e: ERR \u0026ndash; 69%, CR \u0026ndash; 8%\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e: ERR \u0026ndash; 100%c, CR \u0026ndash; 100%\u003c/p\u003e\u003cp\u003eHookworms: ERR \u0026ndash; 99%, CR \u0026ndash; 56%\u003c/p\u003e\u003cp\u003eIntervention arm:\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e: ERR \u0026ndash; 99%, CR -66%\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e: ERR \u0026ndash; 100%, CR \u0026ndash; 100%\u003c/p\u003e\u003cp\u003eHookworms: ERR \u0026ndash; 99%, CR \u0026ndash; 59%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDyer et al. (2023) \u003csup\u003e\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eVietnam\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRandomized controlled trial\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDak Lak Province\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCommunity-wide and school children\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cem\u003eNecator americanus\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eABZ (400 mg) to schoolchildren and the community-wide\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eABZ (400 mg) to schoolchildren only\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eMultiplex qPCR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003eControl arm:\u003c/p\u003e\u003cp\u003eBaseline:\u003c/p\u003e\u003cp\u003ePrevalence \u0026ndash; 16.7%\u003c/p\u003e\u003cp\u003eEPG \u0026ndash; 1678.8\u003c/p\u003e\u003cp\u003e12 mos FU:\u003c/p\u003e\u003cp\u003ePrevalence \u0026ndash; 11.7%\u003c/p\u003e\u003cp\u003eEPG \u0026ndash; 1622.0\u003c/p\u003e\u003cp\u003eIntervention arm\u003c/p\u003e\u003cp\u003eBaseline:\u003c/p\u003e\u003cp\u003ePrevalence \u0026ndash; 11.7%\u003c/p\u003e\u003cp\u003eEPG \u0026ndash; 1699.4\u003c/p\u003e\u003cp\u003e12 mos FU:\u003c/p\u003e\u003cp\u003ePrevalence \u0026ndash; 7.7%\u003c/p\u003e\u003cp\u003eEPG \u0026ndash; 747.7\u003c/p\u003e\u003cp\u003ePrevalence relative reduction:\u003c/p\u003e\u003cp\u003eControl \u0026ndash; 30.1%\u003c/p\u003e\u003cp\u003eIntervention \u0026ndash; 34.6%\u003c/p\u003e\u003cp\u003eEPG relative reduction:\u003c/p\u003e\u003cp\u003eControl \u0026ndash; 3.4%\u003c/p\u003e\u003cp\u003eIntervention \u0026ndash; 56.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWelsche et al. (2024) \u003csup\u003e\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLao PDR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRandomized controlled trial\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNambak district, Luang Prabang\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCommunity-wide\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eABZ (400 mg) and IVM\u003c/p\u003e\u003cp\u003e (200 \u0026micro;g/kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eABZ (400 mg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eKato-Katz thick smear\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003eControl arm:\u003c/p\u003e\u003cp\u003eArithmetic ERR \u0026ndash; 0 to 64.1%\u003c/p\u003e\u003cp\u003eGeometric ERR \u0026ndash; 56.2% to 80.2%;\u003c/p\u003e\u003cp\u003eIntervention arm:\u003c/p\u003e\u003cp\u003eArithmetic ERR \u0026ndash; 91.9% to 97.2%\u003c/p\u003e\u003cp\u003eGeometric ERR \u0026ndash; 98.9% to 99.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNachaiwieng et al. (2024) \u003csup\u003e\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eThailand\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eQuasi-experimental study\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eOmkoi District, Chiang Mai Province\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCommunity-wide\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e and \u003cem\u003eTrichuris\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eABZ (400 mg) with community health education\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eABZ (400 mg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eFormalin ethyl acetate con\u003c/p\u003e\u003cp\u003ecentration method\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003eControl arm:\u003c/p\u003e\u003cp\u003eBaseline prevalence:\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e \u0026ndash; 0.6%\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e \u0026ndash; 1.8%\u003c/p\u003e\u003cp\u003e3 mos FU prevalence:\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e \u0026ndash; 0%\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e \u0026ndash; 1.3%\u003c/p\u003e\u003cp\u003e6 mos FU prevalence\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e \u0026ndash; 0%\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e \u0026ndash; 0.5%\u003c/p\u003e\u003cp\u003eIntervention arm:\u003c/p\u003e\u003cp\u003eBaseline prevalence:\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e \u0026ndash; 0.8%\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e \u0026ndash; 5.4%\u003c/p\u003e\u003cp\u003e3 mos FU prevalence:\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e \u0026ndash; 0%\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e \u0026ndash; 4.8%\u003c/p\u003e\u003cp\u003e6 mos FU prevalence:\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e \u0026ndash; 0.9%\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e \u0026ndash; 6.4%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"10\" nameend=\"c10\" namest=\"c1\"\u003e\u003cp\u003eERR \u0026ndash; Egg Reduction Rate; CR \u0026ndash; Cure Rate; FU \u0026ndash; Follow-up; EPG \u0026ndash; Egg per gram; ABZ \u0026ndash; Albendazole; MBZ \u0026ndash; Mebendazole; IVM \u0026ndash; Ivermectin; DEC \u0026ndash; Diethylcarbamazine; PYR \u0026ndash; Pyrantel pamoate\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eResults from cross-sectional studies included in this review.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eReference and Year of Publication\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCountry\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eLocation\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePopulation\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eSTH studied\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eMDA history\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eTest Used\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eKey Outcomes\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eConlan et al. (2012) \u003csup\u003e\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLao PDR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eOudomxay, Luangprabang, Huaphan, and Xiengkhuang Provinces\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eCommunity-wide, 6\u0026ndash;11-year-old children, Women of childbearing age\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003eAscaris; Trichuris;\u003c/em\u003e Hookworm; \u003cem\u003eStrongyloides\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eHistory of ABZ (400 mg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eFormalin-ether concentration\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eAny STH prevalence: 70.6%\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e prevalence: 26.1%\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e prevalence: 41.5%\u003c/p\u003e\u003cp\u003eHookworm prevalence: 46.3%\u003c/p\u003e\u003cp\u003e\u003cem\u003eStrongyloides\u003c/em\u003e prevalence: 8.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSanza et al. (2013) \u003csup\u003e\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePhilippines\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eAklan, Antique, and Capiz\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eThird-grade students (8\u0026ndash;9 years old)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003eAscaris, Trichuris\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eMBZ (500 mg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eKato-Katz thick smear\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003ePrevalence of STH moderate-to-heavy infection: statistically significant decrease from the baseline\u003c/p\u003e\u003cp\u003eEffect on egg counts: decreased within the first follow-up but increased in the last follow-up.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBelizario et al. (2016) \u003csup\u003e\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePhilippines\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMunicipalities of Aroroy, Cawayan, Milagros, and Monreal in Masbate Province\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePreschool-age children\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eHookworms, \u003cem\u003eAscaris, Trichuris\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e10 years history of MDA with ABZ (400 mg) or MBZ (500 mg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eKato-Katz thick smear\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eSTH prevalence:\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e - 59.0%\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e \u0026minus;\u0026thinsp;54.0%\u003c/p\u003e\u003cp\u003eHookworm \u0026minus;\u0026thinsp;2%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDunn et al. (2017) \u003csup\u003e\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMyanmar\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eUdo village, Taikkyi township, Yangon Region and Kyee Kan Theik village, Nyaung Don township, Ayeyarwaddy Region\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eCommunity-wide\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eHookworms, \u003cem\u003eAscaris, Trichuris\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eABZ (400 mg), DEC (6 mg/kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eKato-Katz thick smear\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eSTH prevalence:\u003c/p\u003e\u003cp\u003eAny STH \u0026minus;\u0026thinsp;27.81%\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e - 5.34%\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e \u0026minus;\u0026thinsp;18.12%\u003c/p\u003e\u003cp\u003eHookworm \u0026minus;\u0026thinsp;8.71%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAsh et al. (2017) \u003csup\u003e\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLao PDR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePhongsaly Province\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eCommunity-wide\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eHookworms, \u003cem\u003eAscaris, Trichuris\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2 MDA with triple ABZ (400 mg) 5 months apart\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eMcMaster egg counting method; PCR species identification\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eMDA1\u003c/p\u003e\u003cp\u003eSTH Prevalence Reduction:\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e - 95.6%\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e \u0026minus;\u0026thinsp;69.2%\u003c/p\u003e\u003cp\u003eHookworm \u0026minus;\u0026thinsp;83.4%\u003c/p\u003e\u003cp\u003eSTH ERR:\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e - 99.4%\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e \u0026minus;\u0026thinsp;77.2%\u003c/p\u003e\u003cp\u003e\u003cem\u003eHookworm\u003c/em\u003e \u0026minus;\u0026thinsp;94.4%\u003c/p\u003e\u003cp\u003eMDA2\u003c/p\u003e\u003cp\u003eSTH Prevalence Reduction:\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e - 93.5%\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e \u0026minus;\u0026thinsp;61%\u003c/p\u003e\u003cp\u003eHookworm \u0026minus;\u0026thinsp;84.5%\u003c/p\u003e\u003cp\u003eSTH ERR:\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e - 99.3%\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e \u0026minus;\u0026thinsp;88.5%\u003c/p\u003e\u003cp\u003eHookworm \u0026minus;\u0026thinsp;97.8%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStaal et al. (2018) \u003csup\u003e\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIndonesia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNangapanda Village, Ende District, Flores Island\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSchool children\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eHookworms, \u003cem\u003eAscaris, Trichuris\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eABZ (400 mg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eKato-Katz thick smear\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eBaseline STH prevalence:\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e - 8.4%\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e \u0026minus;\u0026thinsp;11.2%\u003c/p\u003e\u003cp\u003eHookworm \u0026minus;\u0026thinsp;4.9%\u003c/p\u003e\u003cp\u003eFU STH prevalence\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e - 1.0%\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e \u0026minus;\u0026thinsp;3.9%\u003c/p\u003e\u003cp\u003eHookworm \u0026minus;\u0026thinsp;1.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVaz Nery et al. (2018) \u003csup\u003e\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTimor Leste\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eManufahi municipality\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eCommunity-wide\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003eNecator\u003c/em\u003e and \u003cem\u003eAscaris\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eABZ (400 mg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eReal-time multiplex PCR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cem\u003eN. americanus\u003c/em\u003e\u003c/p\u003e\u003cp\u003eCR \u0026minus;\u0026thinsp;58.3%\u003c/p\u003e\u003cp\u003eInfection intensity reduction \u0026minus;\u0026thinsp;88.9%\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e\u003c/p\u003e\u003cp\u003eCR \u0026minus;\u0026thinsp;91.4%\u003c/p\u003e\u003cp\u003eInfection intensity reduction \u0026minus;\u0026thinsp;95.5%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSungkar et al. (2018) \u003csup\u003e\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIndonesia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePerobatang Village, Southwest Sumba District\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eChildren aged 1\u0026ndash;15 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eHookworms, \u003cem\u003eAscaris, Trichuris\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eTripple dose ABZ (400 mg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eKato-Katz thick smear\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eBaseline STH prevalence:\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e - 65.4%\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e \u0026minus;\u0026thinsp;55.8%\u003c/p\u003e\u003cp\u003eHookworm \u0026minus;\u0026thinsp;15.4%\u003c/p\u003e\u003cp\u003eFU STH prevalence:\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e - 8.3%\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e \u0026minus;\u0026thinsp;12.8%\u003c/p\u003e\u003cp\u003eHookworm \u0026minus;\u0026thinsp;0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDunn et al. (2019) \u003csup\u003e\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMyanmar\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eUdo village, Taikkyi township, Yangon Region and Kyee Kan Theik village, Nyaung Don township, Ayeyarwaddy Region\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eCommunity-wide\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eHookworms, \u003cem\u003eAscaris, Trichuris\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eThrice administration of ABZ (400 mg) 4 and 6 mos apart\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eKato-Katz thick smear\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eBaseline STH prevalence:\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e - 5.5%\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e \u0026minus;\u0026thinsp;17.02%\u003c/p\u003e\u003cp\u003eHookworm \u0026minus;\u0026thinsp;9.75%\u003c/p\u003e\u003cp\u003e1st FU STH prevalence:\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e - 1.72%\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e \u0026minus;\u0026thinsp;11.82%\u003c/p\u003e\u003cp\u003eHookworm \u0026minus;\u0026thinsp;6.69%\u003c/p\u003e\u003cp\u003e2nd FU STH prevalence:\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e - 2.49%\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e \u0026minus;\u0026thinsp;11.85%\u003c/p\u003e\u003cp\u003eHookworm \u0026minus;\u0026thinsp;5.54%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eChai et al. (2020) \u003csup\u003e\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMyanmar\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSouth Dagon, North Dagon, and Hlaing-thar-yar of\u003c/p\u003e\u003cp\u003eYangon Region\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSchool children\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eHookworms, \u003cem\u003eAscaris, Trichuris\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eABZ (400 mg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eKato-Katz thick smear\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eSTH prevalence:\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e - 17.2%\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris \u0026minus;\u003c/em\u003e\u0026thinsp;19.4%\u003c/p\u003e\u003cp\u003eHookworm \u0026minus;\u0026thinsp;0.2%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStracke et al. (2021) \u003csup\u003e\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eThailand\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMae Song subdistrict, Tha Song Yang district, Tak Province\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2- to 6-year-old pre-school and school-aged children\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003eAncylostoma ceylanicum, Ascaris, Trichuris\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eHistory of annual MBZ (500 mg) administration\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003emultiplexed-tandem qPCR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eSTH prevalence:\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e - 39.2%\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e \u0026minus;\u0026thinsp;36.6%\u003c/p\u003e\u003cp\u003e\u003cem\u003eA. ceylanicum\u003c/em\u003e \u0026minus;\u0026thinsp;1.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eColella et al. (2021) \u003csup\u003e\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCambodia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eChambak Pa\u0026rsquo;em, Chamlong, Kam-pot, Rovieng Tboung, Sangker Roung, Pal Hal, Anglong Svay, Cham-long, Bos Pey and Sra\u0026rsquo;er Thom, Rovieng district, Preah Vihear Province\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eCommunity-wide and animals\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003eAncylostoma ceylanicum\u003c/em\u003e and \u003cem\u003eNecator americanus\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eABZ (400 mg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003emultiplex qPCR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eHookworm CR \u0026minus;\u0026thinsp;46.4%\u003c/p\u003e\u003cp\u003e\u003cem\u003eN. americanus\u003c/em\u003e CR \u0026minus;\u0026thinsp;48.3%\u003c/p\u003e\u003cp\u003e\u003cem\u003eA. ceylanicum\u003c/em\u003e CR \u0026minus;\u0026thinsp;52.6%\u003c/p\u003e\u003cp\u003eHookworms:\u003c/p\u003e\u003cp\u003eGeometric ERR \u0026minus;\u0026thinsp;83.2%\u003c/p\u003e\u003cp\u003eArithmetic ERR \u0026minus;\u0026thinsp;72.5%\u003c/p\u003e\u003cp\u003e\u003cem\u003eN. americanus\u003c/em\u003e:\u003c/p\u003e\u003cp\u003eGeometric ERR \u0026minus;\u0026thinsp;84.5%\u003c/p\u003e\u003cp\u003eArithmetic ERR \u0026minus;\u0026thinsp;77.6%\u003c/p\u003e\u003cp\u003e\u003cem\u003eA. ceylanicum\u003c/em\u003e:\u003c/p\u003e\u003cp\u003eGeometric ERR \u0026minus;\u0026thinsp;98.7%\u003c/p\u003e\u003cp\u003eArithmetic ERR \u0026minus;\u0026thinsp;62.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHong et al. (2021) \u003csup\u003e\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMyanmar\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eShwe Pyi Thar, Twantay, and Kyauktan,\u003c/p\u003e\u003cp\u003eYangon Region\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePrimary school-children\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eHookworms, \u003cem\u003eAscaris, Trichuris\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eNine rounds of ABZ (400 mg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eKato-Katz thick smear\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e1st FU prevalence:\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e \u0026minus;\u0026thinsp;23.3%; \u003cem\u003eTrichuris\u003c/em\u003e \u0026minus;\u0026thinsp;23.3%; Hookworms \u0026minus;\u0026thinsp;0.1%\u003c/p\u003e\u003cp\u003e2nd FU prevalence:\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e \u0026minus;\u0026thinsp;17.3%; \u003cem\u003eTrichuris\u003c/em\u003e \u0026minus;\u0026thinsp;26.2%;\u003c/p\u003e\u003cp\u003eHookworms \u0026minus;\u0026thinsp;0.8%\u003c/p\u003e\u003cp\u003e3rd FU prevalence:\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e \u0026minus;\u0026thinsp;17.3%; \u003cem\u003eTrichuris\u003c/em\u003e \u0026minus;\u0026thinsp;27.4%; Hookworms \u0026minus;\u0026thinsp;0.3%\u003c/p\u003e\u003cp\u003e4th FU prevalence:\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e \u0026minus;\u0026thinsp;2.9%; \u003cem\u003eTrichuris\u003c/em\u003e \u0026minus;\u0026thinsp;21.3%; Hookworms \u0026minus;\u0026thinsp;0%\u003c/p\u003e\u003cp\u003e5th FU prevalence:\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e \u0026minus;\u0026thinsp;7.2%; \u003cem\u003eTrichuris\u003c/em\u003e \u0026minus;\u0026thinsp;14.5%; Hookworms \u0026minus;\u0026thinsp;0.2%\u003c/p\u003e\u003cp\u003e6th FU prevalence:\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e \u0026minus;\u0026thinsp;3.6%; \u003cem\u003eTrichuris\u003c/em\u003e \u0026minus;\u0026thinsp;20.2%; Hookworms \u0026minus;\u0026thinsp;0.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eTee et al. (2022)\u003c/span\u003e \u003csup\u003e\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMalaysia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRasau (Perak state), Sungai Judah, Tanjung Sepat and Bukit Bangkon, Selangor States\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eCommunity-wide, aged four and 85 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eHookworms, \u003cem\u003eAscaris, Trichuris\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3-day course of \u003c/p\u003e\u003cp\u003e ABZ (400mg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eModified Kato-Katz technique\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3 wk FU:\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e: CR \u0026minus;\u0026thinsp;100%, ERR \u0026minus;\u0026thinsp;100%\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e: CR \u0026minus;\u0026thinsp;64.6%, ERR \u0026minus;\u0026thinsp;94.2% Hookworm: CR \u0026minus;\u0026thinsp;100%, ERR \u0026minus;\u0026thinsp;100%\u003c/p\u003e\u003cp\u003e6 wk FU:\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e: no infection\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e: 25.8% prevalence, 250.2 EPG Hookworm: no infection\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLe et al. (2023) \u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTimor Leste\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eDili, Ermera, and Manufahi municipalities\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSchoolchildren\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003eAscaris, Trichuris, N. americanus, Ancylostoma ceylanicum, An. duodenale\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eIVM\u003c/p\u003e\u003cp\u003e(200 \u0026micro;g/kg), DEC (6 mg/kg), \u003c/p\u003e\u003cp\u003eand ABZ(400 mg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eMultiplex qPCR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eBaseline prevalence:\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e \u0026minus;\u0026thinsp;18.1%,\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e \u0026minus;\u0026thinsp;4.8%\u003c/p\u003e\u003cp\u003e\u003cem\u003eN. americanus\u003c/em\u003e \u0026minus;\u0026thinsp;7.4%\u003c/p\u003e\u003cp\u003e\u003cem\u003eA. ceylanicum\u003c/em\u003e \u0026minus;\u0026thinsp;0.6%\u003c/p\u003e\u003cp\u003e\u003cem\u003eA. duodenale\u003c/em\u003e \u0026minus;\u0026thinsp;0.2%\u003c/p\u003e\u003cp\u003e18 mos FU prevalence:\u003c/p\u003e\u003cp\u003e\u003cem\u003eAscaris\u003c/em\u003e \u0026minus;\u0026thinsp;13.2%\u003c/p\u003e\u003cp\u003e\u003cem\u003eTrichuris\u003c/em\u003e \u0026minus;\u0026thinsp;0.6%\u003c/p\u003e\u003cp\u003e\u003cem\u003eN. americanus\u003c/em\u003e \u0026minus;\u0026thinsp;5.9%\u003c/p\u003e\u003cp\u003e\u003cem\u003eA. ceylanicum\u003c/em\u003e \u0026minus;\u0026thinsp;3.4%\u003c/p\u003e\u003cp\u003e\u003cem\u003eA. duodenale\u003c/em\u003e \u0026minus;\u0026thinsp;0%.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e\u003cp\u003eERR \u0026ndash; Egg Reduction Rate; CR \u0026ndash; Cure Rate; FU \u0026ndash; Follow-up; EPG \u0026ndash; Egg per gram; ABZ \u0026ndash; Albendazole; MBZ \u0026ndash; Mebendazole; IVM \u0026ndash; Ivermectin; DEC \u0026ndash; Diethylcarbamazine\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\u003ch2\u003e3.2. Benzimidazoles as the primary intervention\u003c/h2\u003e\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eAmong the selected studies, BZ drugs, like ABZ (400 mg) and MBZ (500 mg), were the most used interventions in mass chemotherapy efforts (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eD). Indeed, MDA with BZ monotherapy remains the cornerstone of control and elimination efforts against STH infections.\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e,\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e This is particularly true in other endemic regions like South America \u003csup\u003e\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e,\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e\u003c/sup\u003e, South Asia \u003csup\u003e\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e\u003c/sup\u003e and Africa \u003csup\u003e\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e,\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e\u003c/sup\u003e. Several SEA nations recognized the serious threat of STH infections early and established control programs: Malaysia in 1974, Indonesia in 1975, Thailand in 1980, and the Philippines in 1999.\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e Likewise, school-based deworming efforts were initiated in Vietnam, Lao PDR, and Myanmar with aid from foreign agencies and support from affluent countries.\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e Some of these programs were discontinued due to lack of funding or were reliant on donations, loans, and support from foreign agencies for the drugs needed for mass PC.\u003csup\u003e6\u003c/sup\u003e At the turn of the millennium, renewed enthusiasm for MDA against STH infections was seen. For instance, a 95% MDA coverage was reported during a country-wide, school-based deworming program that was conducted in Lao PDR in 2006.\u003csup\u003e\u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e\u003c/sup\u003e Likewise, the high infection prevalence reported previously prompted the Philippine government to implement the Integrated Helminth Control Program in 2006, which is still ongoing.\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e,\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e,\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e,\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e\u003c/sup\u003e Similar efforts were implemented in Indonesia through governmental programs and in Cambodia through foreign support.\u003csup\u003e\u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eSeveral cross-sectional studies included in this review assessed the effects of BZ monotherapy on infection prevalence. For instance, Sanza et al. \u003csup\u003e40\u003c/sup\u003e reported a significant drop in STH prevalence in several provinces in central Philippines that have received several rounds of Mebendazole monotherapy. Similarly, a preliminary study by Staal et al. \u003csup\u003e44\u003c/sup\u003e in Indonesia reported a decrease in \u003cem\u003eA. lumbricoides, T. trichiura\u003c/em\u003e, and hookworm infection prevalence at follow-up post ABZ treatment. Monotherapy and combination therapy studies also reported the effects of the cure rates (CR) and egg reduction rates (ERR). An early trial by Soukhathammavong et al. \u003csup\u003e30\u003c/sup\u003e observed that subpar CR (less than 95%) against \u003cem\u003eA. lumbricoides\u003c/em\u003e but had superior ERR at 100%. Disappointing CRs and ERRs were found among hookworms and \u003cem\u003eT. trichiura.\u003c/em\u003e A similar trend was observed by Levecke et al. \u003csup\u003e31\u003c/sup\u003e in trials conducted in Vietnam and Cambodia and by Vaz Nery et al. \u003csup\u003e45\u003c/sup\u003e in Timor Leste among school-aged children. A communitywide study by Ash et al. \u003csup\u003e43\u003c/sup\u003e in Lao PDR found that two rounds of triple-dose ABZ significantly reduced the prevalence of \u003cem\u003eA. lumbricoides\u003c/em\u003e and hookworm infections, and the treatment had superior ERR in these helminths. Both prevalence reduction and ERR in \u003cem\u003eT. trichiura\u003c/em\u003e were lowered.\u003csup\u003e\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e\u003c/sup\u003e Communitywide treatment with ABZ, as observed by Dyer et al. \u003csup\u003e36\u003c/sup\u003e, caused a better prevalence and intensity of infection reductions when compared to only giving treatment to schoolchildren in Vietnam. The use of BZ drugs for the control and elimination of STH infections relies on their efficacy, as proven in the cited studies above, their safety, and ease of administration.\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e The challenge, however, is varied efficacies among the different STH species.\u003csup\u003e\u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e\u003c/sup\u003e Hence, its combination with other dewormers from different classes has been explored.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\u003ch2\u003e3.3. Combination therapy: the new frontier?\u003c/h2\u003e\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eStudies that assessed the effect of combination therapy against STH infections also reported varying outcomes. Sapulete et al. \u003csup\u003e26\u003c/sup\u003e assessed the efficacy of combining PYR and ABZ in comparison to ABZ treatment alone in school children from Indonesia. The addition of PYR treatment increased the CR by 20%.\u003csup\u003e26\u003c/sup\u003e Another trial by Keller et al \u003csup\u003e34\u003c/sup\u003e that utilized the IVM\u0026thinsp;+\u0026thinsp;ABZ versus ABZ monotherapy observed that those receiving the combination treatment showed superior ERR at 2 to 3 weeks, 6 months, and 1 year after the treatment. Utilizing qPCR as their diagnostic tool, H\u0026uuml;rlimann et al. \u003csup\u003e25\u003c/sup\u003e reported that the ABZ\u0026thinsp;+\u0026thinsp;IVM treatment had superior \u003cem\u003eA. lumbricoides, T. trichiura\u003c/em\u003e, and hookworm CRs and ERRs compared to ABZ monotherapy. The addition of DEC, IVM, and ABZ resulted in reduced infection prevalence of several hookworm species.\u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e Other reports from other regions affirm the enhanced efficacy when BZs are combined with IVM. A recent meta-analysis showed enhanced prevalence reduction when ABZ\u0026thinsp;+\u0026thinsp;IVM was used against \u003cem\u003eT. trichiura\u003c/em\u003e infections compared to IVM alone: 89.40% vs. 49.93%, respectively.\u003csup\u003e\u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e\u003c/sup\u003e Against strongyloidiasis, however, IVM (84.49%) alone was slightly better in reducing infection prevalence than ABZ\u0026thinsp;+\u0026thinsp;IVM (81.37%).\u003csup\u003e62\u003c/sup\u003e In India, ABZ\u0026thinsp;+\u0026thinsp;IVM was also shown to increase the ERR of \u003cem\u003eA. lumbricoides\u003c/em\u003e when compared to ABZ monotherapy: 93.22% vs. 90.61%, respectively.\u003csup\u003e\u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e63\u003c/span\u003e\u003c/sup\u003e A cross-sectional study in a population receiving concurrent ABZ\u0026thinsp;+\u0026thinsp;IVM mass treatment in Cameroon found that the drug combination could have collateral impacts that can hasten control and elimination of STH.\u003csup\u003e\u003cspan citationid=\"CR64\" class=\"CitationRef\"\u003e64\u003c/span\u003e\u003c/sup\u003e Moreover, ABZ\u0026thinsp;+\u0026thinsp;IVM\u0026rsquo;s efficacy in reducing the incidence of STH-associated anemia and infections, and their relative safety during pregnancy was assessed in Uganda.\u003csup\u003e\u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e\u003c/sup\u003e The results of the included studies in our review and those from the literature indicate that adding drugs from different classes to BZs improved the efficacy of treatments across a variety of STH species that affect populations within endemic areas. This point was highlighted by Emerson et al. \u003csup\u003e66\u003c/sup\u003e when they pointed out that combination therapy with appropriate drugs targeted toward the most susceptible helminth species can hasten the achievement of global control and elimination targets and therefore lessen the risk of resistance development.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003e3.4. PC with Health Education and WASH initiatives: the ol\u0026rsquo; reliables\u003c/h2\u003e\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eThe combination of non-pharmaceutical interventions with drug-based treatments also showed promising effects on STH infections. The \u0026lsquo;Fit for School\u0026rsquo; program, which included daily handwashing with soap, daily brushing with fluoride toothpaste, and biannual deworming with ABZ, resulted in reduced prevalence of STH infections of moderate to heavy intensity.\u003csup\u003e\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e Another innovation in health education was the incorporation of Magic Glasses, which is a health education intervention aimed at preventing intestinal worms in schoolchildren that involves using engaging cartoon videos and educational materials.\u003csup\u003e\u003cspan citationid=\"CR67\" class=\"CitationRef\"\u003e67\u003c/span\u003e\u003c/sup\u003e The trial done by Mationg et al. \u003csup\u003e35\u003c/sup\u003e in the Philippines showed that the integration of the Magic Glasses program into the biannual ABZ administration program resulted in insignificant changes in the infection prevalence but markedly improved the knowledge and behavior of the schoolchildren receiving the intervention. Aside from health education, the provision of WASH infrastructure with deworming also improved infection control. A preliminary study showed that the provision of latrines and health education, together with ABZ treatment, significantly decreased the STH infection prevalence in schoolchildren in Indonesia.\u003csup\u003e\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u003c/sup\u003e These results show the value of incorporating health education and WASH initiatives with drug administration for the control and elimination of STH infections. Recently, Mationg et al. \u003csup\u003e67\u003c/sup\u003e conducted a review of studies that assessed the effectiveness of health education packages against STH and their impacts on infection control. They found only three studies, highlighting the neglect of this intervention in the current drug-based paradigm. As the included papers in our review purport, health education plays a crucial role in improving the knowledge and attitudes of the target populations. Likewise, improving WASH facilities enables the elimination of open defecation and improves hygiene practices that result in STH infection prevention and avert reinfection.\u003csup\u003e\u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e68\u003c/span\u003e\u003c/sup\u003e A multi-pronged approach that includes health education and WASH facility provision with mass treatment can facilitate faster achievement of control and elimination targets.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003e3.5. Indications of diminished efficacy\u003c/h2\u003e\u003cp\u003eSeveral alarming reports of reduced mass treatment efficacies, in comparison to the guidelines set by the WHO \u003csup\u003e\u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e\u003c/sup\u003e, were documented by some of the included studies. The WHO guideline stipulates that an anthelmintic drug's effectiveness is categorized as \"satisfactory\" if its ERR meets or exceeds the reference value, and as \"doubtful\" or \"reduced\" if the ERR falls below the reference value by less or more than 10 percentage points, respectively.\u003csup\u003e\u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e\u003c/sup\u003e The aforementioned study comparing the efficacy of ABZ and MBZ in Lao PDR reported doubtful ERR (i.e., less 10 percentage points less than the 90% satisfactory value) among hookworms when the former was administered.\u003csup\u003e\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u003c/sup\u003e More recently, Colella et al. \u003csup\u003e50\u003c/sup\u003e used qPCR to assess the efficacy of ABZ treatment and showed diminished efficacy because ERRs of hookworm infections in Cambodia were reduced (i.e., more than 10 percentage points less than the 90% satisfactory value). A similar trend was also observed in Timor-Leste, where ABZ treatment did not result in ERRs for \u003cem\u003eN. americanus\u003c/em\u003e that were within satisfactory levels.\u003csup\u003e\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e\u003c/sup\u003e Persistent prevalence despite the histories of repeated treatments was also reported. A history of BZ treatment in schoolchildren and women of reproductive age failed to cut the prevalence of \u003cem\u003eA. lumbricoides, T. trichiura\u003c/em\u003e, and hookworms in northern Lao PDR where it remained relatively high.\u003csup\u003e\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e\u003c/sup\u003e In Myanmar, six rounds of ABZ treatment failed to consistently bring down the prevalence of \u003cem\u003eT. trichiura\u003c/em\u003e infections. \u003csup\u003e51\u003c/sup\u003e A decade of MDA with BZ drugs in schoolchildren in the Philippines also failed to reduce the STH infection prevalence\u0026mdash;more than 50% in \u003cem\u003eA. lumbricoides\u003c/em\u003e and \u003cem\u003eT. trichiura\u003c/em\u003e\u0026mdash;to reach the national and global control targets.\u003csup\u003e\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e\u003c/sup\u003e Reduced ABZ efficacy against \u003cem\u003eA. lumbricoides\u003c/em\u003e and \u003cem\u003eT. trichiura\u003c/em\u003e has also been reported in Gabon \u003csup\u003e\u003cspan citationid=\"CR69\" class=\"CitationRef\"\u003e69\u003c/span\u003e\u003c/sup\u003e and Ethiopia \u003csup\u003e\u003cspan citationid=\"CR70\" class=\"CitationRef\"\u003e70\u003c/span\u003e\u003c/sup\u003e. These results indicate that mass treatments with BZs may have reduced efficacy depending on the species of the helminth and the drug used. This issue provides an opportunity for combination therapy regimens that can enhance efficacy, as proven by the studies mentioned in the previous section. The long-term consequences of combination treatment against STH have yet to be fully assessed. However, the emergence of multidrug-resistant STH has been raised as a concern as a consequence of combination therapy.\u003csup\u003e\u003cspan additionalcitationids=\"CR72\" citationid=\"CR71\" class=\"CitationRef\"\u003e71\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR73\" class=\"CitationRef\"\u003e73\u003c/span\u003e\u003c/sup\u003e Likewise, evidence of multidrug-resistant animal hookworms due to protracted use of combination therapy in the United States and Canada should also be kept in mind.\u003csup\u003e\u003cspan additionalcitationids=\"CR75\" citationid=\"CR74\" class=\"CitationRef\"\u003e74\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR76\" class=\"CitationRef\"\u003e76\u003c/span\u003e\u003c/sup\u003e The role of other factors (i.e., treatment coverage and compliance) needs to be thoroughly evaluated in all endemic countries in SEA. Moreover, the indication of resistance has yet to be fully elucidated by field data in this region. Guidelines on the determination of resistance in STH have yet to be promulgated. \u003csup\u003e77\u003c/sup\u003e Only guidelines for the assessment of PC efficacy against STH and schistosomiasis have been established by the WHO.\u003csup\u003e\u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eOur comprehensive review has some limitations. First, we were not able to incorporate data from governmental databases due to the focus on peer-reviewed literature only. Some PC efforts may not be described in peer-reviewed literature. However, through extensive searches and sufficient selection and eligibility criteria, we were able to include studies that were done in areas where government-implemented MDA was being done, such as those in the Philippines \u003csup\u003e\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e,\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e\u003c/sup\u003e and Lao PDR \u003csup\u003e\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e\u003c/sup\u003e. Secondly, the variability in the sample sizes, control groups used (if necessary), outcomes measured, and study designs hamper the integrated analysis of the data from the included studies. Despite these issues, our utilization of appropriate risk-of-bias tools allowed for the assessment of each study's quality, confirming that the included results and their synthesis were of acceptable scientific merit.\u003c/p\u003e\u003c/div\u003e"},{"header":"4. Conclusion","content":"\u003cp\u003eThis comprehensive review aimed to update knowledge on mass treatment for STH control in SEA countries by collecting and synthesizing peer-reviewed literature. We searched several databases and included 27 studies that passed our screening and eligibility criteria. These papers were of different study designs and utilized various drug interventions. BZ drugs, like ABZ and MBZ, remained the most used anthelmintic in mass deworming efforts in the region with often satisfactory but inconsistent results in terms of efficacy and reducing infection prevalence. An emerging trend that the papers reported on is the combination of anthelmintics from different classes with BZs to enhance efficacy. Moreover, comprehensive efforts that include health education and WASH facility improvement with deworming result in enhanced infection reduction. Several reports have documented diminished efficacies\u0026mdash;insufficient ERRs and failure to significantly reduce infection prevalence\u0026mdash;when BZs are used against hookworms and \u003cem\u003eT. trichiura\u003c/em\u003e infections. Combination therapy (e.g., ABZ\u0026thinsp;+\u0026thinsp;IVM) provides an opportunity to address this issue and enhance efficacy. Therefore, judicious combination therapy with health education packages and improvement of WASH can hasten the achievement of control and elimination targets and abate the threat of resistance.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eSTH\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eSoil-transmitted helminths\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eWHO\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eWorld Health Organization\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eWASH\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eWater, sanitation and hygiene\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eSEA\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eSoutheast Asia\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eMDA\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eMass Drug Administration\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eASEAN\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eAssociation of Southeast Asian Nations\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003ePC\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003ePreventive Chemotherapy\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eBZ\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eBenzimidazole\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eABZ\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eAlbendazole\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eMBZ\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eMebendazole\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eIVM\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eIvermectin\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eDEC\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eDiethylcarbamazine\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003ePYR\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003ePyrantel pamoate\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eCR\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eCure Rate\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eERR\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eEgg Reduction Rate\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003ePCR\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003ePolymerase Chain Reaction\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eSupplementary Materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSupplementary tables and figures are available at [DOI]\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eJCBT and AK would like to acknowledge the Postgraduate Scholarship for International Students of the Faculty of Medicine, Khon Kaen University for funding their doctoral studies. Also, MFH acknowledges Khon Kaen University Active Recruitment Scholarships for funding his master\u0026rsquo;s degree studies. SS is supported by the Fundamental Fund of Khon Kaen University and the National Science, Research, and Innovation Fund.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eJCBT\u003cstrong\u003e:\u0026nbsp;\u003c/strong\u003eConceptualization; Writing -Original Draft; Methodology; Formal Analysis. MFH\u003cstrong\u003e:\u0026nbsp;\u003c/strong\u003eMethodology; Writing \u0026ndash; Editing and Reviewing. AK: Methodology; Writing \u0026ndash; Editing and Reviewing. SS and PS: Conceptualization; Writing \u0026ndash; Editing and Reviewing; Supervision.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDue to the nature of this research, data was not generated. All information used for analysis is provided herein and in the supplementary materials.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no competing interests to declare.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research did not receive any funding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics Statements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthics clearance is not required due to the nature of the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for Publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable due to the nature of the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDeclaration of Generative AI in the Writing Process\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLarge language models were not used to generate text for this review.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical Trial Registration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable due to the nature of the study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eLebu S, Kibone W, Muoghalu CC et al (2023) Soil-transmitted helminths: A critical review of the impact of co-infections and implications for control and elimination. 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Webster JP, ed. \u003cem\u003ePLoS Negl Trop Dis\u003c/em\u003e. ;13(4):e0007201. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1371/journal.pntd.0007201\u003c/span\u003e\u003cspan address=\"10.1371/journal.pntd.0007201\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Khon Kaen University","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Mass Drug Administration, Neglected Tropical Disease, Benzimidazoles, Public Health Programs","lastPublishedDoi":"10.21203/rs.3.rs-7089344/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7089344/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eSoil-transmitted helminth (STH) infections continue to pose a significant health threat in Southeast Asia, where a third of global infections are estimated to occur. Preventive chemotherapy (PC) through mass treatments has been recommended by the World Health Organization (WHO) to combat infections and their dire consequences in susceptible populations. This review aims to update PC efforts for STH infection control in Southeast Asia. We systematically searched MEDLINE via PubMed, ScienceDirect, Scopus, EBSCO Host, and ProQuest using specific terms for papers published from 2011 to 2025. From the 4294 initial search hits, 27 studies were included in this research. All Southeast Asian countries, except Brunei Darussalam and Singapore, were represented. Benzimidazole (BZ) drugs, Albendazole (400 mg) and Mebendazole (500 mg), were the most used drug interventions in PC efforts. BZ treatment effectively reduced STH prevalence and intensity, reinforcing its role in control programs. However, recent research showed that BZ treatments failed to reduce infection prevalence and had diminished efficacy. Combination therapies, such as Ivermectin (200 \u0026micro;g/kg)\u0026thinsp;+\u0026thinsp;Albendazole (400 mg), enhanced treatment outcomes across STH species. Integrating health education and WASH improvements further strengthened infection control alongside PC. Combination therapy with health education and WASH improvement can accelerate control and elimination. Our review provides valuable insights for strengthening STH control programs in SEA, advocating for a multi-faceted approach informed by current evidence.\u003c/p\u003e","manuscriptTitle":"A systematic review of preventive chemotherapy against soil-transmitted helminth infections in Southeast Asia: Combination therapy, enhanced WASH, and integrated health education to accelerate control","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-20 04:00:35","doi":"10.21203/rs.3.rs-7089344/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"91f6e695-37f5-4422-8e4c-339e609f2213","owner":[],"postedDate":"October 20th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":56438039,"name":"Parasitology"}],"tags":[],"updatedAt":"2025-10-20T04:00:35+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-20 04:00:35","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7089344","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7089344","identity":"rs-7089344","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}