Effectiveness of community-led total sanitation and health education against helminth infections in Côte d’Ivoire: a cluster-randomised factorial trial with 38 months of follow-up

Effectiveness of community-led total sanitation and health education against helminth infections in Côte d’Ivoire: a cluster-randomised factorial trial with 38 months of follow-up | 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 Research Article Effectiveness of community-led total sanitation and health education against helminth infections in Côte d’Ivoire: a cluster-randomised factorial trial with 38 months of follow-up Gaoussou Coulibaly, Eveline Hürlimann, Mamadou Ouattara, Dongo Kouassi, and 10 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9191647/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 6 You are reading this latest preprint version Abstract Background Parasitic infections remain an important public health problem in low- and middle-income countries. Preventive chemotherapy is the main strategy to control helminthiasis, but rapid reinfection occurs in settings that lack clean water, sanitation and hygiene. This study aimed to assess the effectiveness of community-led total sanitation (CLTS) with or without health education on infections with soil-transmitted helminths, schistosomes and intestinal protozoa. Methods We conducted a longitudinal, repeated cross-sectional cluster-randomised trial within 56 communities in Côte d’Ivoire. Households that had at least one child aged 5–15 years were eligible. After a baseline parasitological and knowledge, attitudes, practice and behaviour (KAPB) questionnaire survey, villages were randomly assigned 1:1:1:1 to one of the four groups: (i) CLTS; (ii) health education; (iii) both interventions combined; and (iv) no intervention. All communities received annual preventive chemotherapy. Two follow-up surveys at 17 and 38 months post-intervention assessed the effects of the interventions on primary (infection with any soil-transmitted helminth species) or secondary (infection with schistosomes and intestinal protozoa) outcomes. The primary analysis compared the effect of CLTS on hookworm infection status. Results Participants were recruited in August and September 2014. Fifty-four localities with 1,246 households including 5,230 participants were randomised, as follow: 13 villages to CLTS, 14 villages to health education, 13 villages to both and 14 villages to no intervention. No significant differences were observed in terms of hookworm prevalence in CLTS and control villages for both follow-up surveys: (i) follow-up at 17 months [59/1,552 (3.8%) vs 69/1,594 (4.3%); odds ratio (OR) = 0.87, 95% confidence interval (CI) 0.45 to 1.68, p = 0.69] and follow-up at 38 months [26/1,212 (2.1%) vs 24/1,278 (1.9%); OR 1.15, 95% CI 0.60 to 2.17, p = 0.68]. Subgroup analysis using localities that achieved at least 75% latrine coverage vs no-CLTS localities, revealed no specific differences in reinfection. Conclusions Our study highlights that the effectiveness of CLTS interventions in preventing helminth and intestinal protozoa infections varies. CLTS may be effective if the baseline prevalence is high but the synergistic effect when combined with regular preventive chemotherapy appears to be limited in this setting. Trial Registration ISRCTN53102033 Cluster randomised trial community-led total sanitation Côte d’Ivoire helminths intestinal protozoa reinfection Figures Figure 1 Figure 2 Figure 3 Figure 4 Background Parasitic infections are common, particularly in resource-limited setting, where personal hygiene and access to clean water and sanitation (safe disposal of human faeces and urine) is often poor[ 1 , 2 ]. It is estimated that more than a billion people are affected by soil-transmitted helminthiasis (STH), schistosomiasis and intestinal protozoa infections (e.g. amoebiasis and giardiasis), causing an estimated 3.5 million disability-adjusted life years[ 3 , 4 ]. The global control strategy for helminthiasis is preventive chemotherapy through regular administration of deworming drugs to entire populations at risk. Albendazole or mebendazole against soil-transmitted helminthiasis and praziquantel against schistosomiasis are the current drugs of choice[ 5 ]. However, preventive chemotherapy does not protect patients from reinfections[ 6 ]. The optimal strategy to control the transmission of these diseases is based on three pillars: (i) large-scale deworming to gradually reduce the infection burden; (ii) improved water, sanitation and hygiene (WASH) to reduce environmental contamination with infectious stages; and (iii) health education to alter behaviour to reduce environmental contamination and risk of infection. Integrated approaches combining several pillars of control hold promise for improving the cost-effectiveness of interventions and thus ensuring the sustainability of control activities in resource-constrained settings. Community-led total sanitation (CLTS) represents a participatory approach that has been developed as a strategy to reduce the incidence of diarrhoea and intestinal infections by putting an end to open defecation and maintaining this status within communities[ 7 ]. In a pilot study carried out in the Taabo health and demographic surveillance system (HDSS) in Côte d’Ivoire, the impact on parasitic infections and attitudes and practices towards WASH of an intervention package, including CLTS and health education, was tested in nine communities within the Taabo HDSS between 2011 and 2012[ 8 ]. Promising effects on hookworm prevalence and intensity as well as lower follow-up infection rates with intestinal protozoa in communities receiving the intervention were observed. However, this study was conducted at small scale and was limited by its design, as it lacked a randomised controlled trial set-up to address potential baseline discrepancies between group assignments and a short interval between baseline and follow-up assessment. In August 2013, a project was launched in 56 communities in the south-central part of Côte d’Ivoire with the aim to assess and quantify the effect of preventive chemotherapy, combined with either CLTS, or health education, or both measures combined, on reinfection with soil-transmitted helminths, schistosomes and intestinal protozoa, using a cluster randomised controlled trial (RCT) design[ 9 ]. Additionally, the effect of the interventions on the incidence of diarrhoea was determined. Here we present the impact data on the parasitic infections that were assessed at three different timepoints during the overall trial duration of 38 months. Methods Study area and population The study was implemented in 56 communities in three departments in the south-central part of Côte d’Ivoire (i.e. Taabo, Djékanou and Toumodi). People are mainly engaged in subsistence agriculture, whereas rubber, cocoa and coffee are farmed as cash crops. Initially, the study was planned to comprise 56 localities in the department of Taabo alone, because of the presence of an HDSS that monitored a population of about 42,000 people when the trial was launched[10]. However, the number of appropriately sized communities according to implementation of CLTS in the Taabo department was lower than expected, and hence, the study was extended into the adjacent departments of Djékanou and Toumodi to obtain the required number of localities. To that end, our study involved 40 localities in Taabo, nine in Djékanou and seven in Toumodi. Factorial cluster randomised trial design Randomisation occurred after baseline data collection was completed. Sample size calculation was done using the Web-based sample calculator for cluster randomised trials presented elsewhere[11], assuming a baseline hookworm prevalence of 30% according to previous studies in the region[12,13], a prevalence reduction of 50% after implementation of interventions[8], an intra-cluster correlation of 0.4. The high correlation within the community was assumed because of the participatory nature of the interventions. Assuming a dropout rate of 30% at each follow-up we estimated that 40 clusters with 152 individuals per cluster are required to achieve 80% power at the 5% significance level. In Côte d’Ivoire, the average number of people per household in the study area is 7[12] (our assumption was 2 adults and 5 children). For a sample size of 152 children per community, we therefore included 30 households per community. The communities were selected based on their population size. We intended to include communities with at least 30 households and a population size not exceeding 600 individuals because this is the optimal recommended size for implementation of the CLTS intervention[7]. Given the demographic characteristics of the study area, somewhat smaller communities (slightly less than 30 households) and villages exceeding 600 individuals were also included. The selection of up to 30 households per community was done at random, according to the World Health Organization’s (WHO) Expanded Programme on Immunization (EPI) method[14]. Our main target group were children aged 5-15 years, on whom sample size calculation was based. Additionally, whenever possible, 1 pre-school-aged child (15 years) from each household were also selected. All the 3 categories of participants underwent parasitological examinations. Household heads (or their spouses/partners) were administered a questionnaire for knowledge, attitudes, practices and beliefs (KAPB), whereas direct observations in each household were done to check for the presence, use and maintenance of latrines as well as potential open defecation and waste disposal sites in close proximity. The trial communities were assigned by restricted randomisation to 1 of 4 intervention arms with 14 communities per intervention arm based on baseline hookworm (the most prominent soil-transmitted helminth species identified in the area) prevalence and population size[15,16]. The control and 3 intervention arms are as follows: (i) control arm; (ii) CLTS; (iii) health education; and (iv) CLTS and health education, resulting in a 2 × 2 factorial design. In addition, all villages received annual preventive chemotherapy. Figure 1 shows the study area with the 56 selected communities, stratified by study arm. Interventions started right after randomisation of the communities. Assessments A first follow-up parasitological and KAPB questionnaire survey was carried out 17 months after the baseline cross-sectional survey. A second follow-up survey was scheduled another 21 months later. At the end of the CLTS intervention, the communities were visited and inspected using standardised forms. Transects were done to assess whether open defecation and waste disposal spots were visible and all households were inspected for the availability of latrines. An overview of the activities during the study (from August 2014 to November 2017) is provided in Figure 2. Interventions The interventions were implemented after the baseline cross-sectional survey[15]. The CLTS intervention was started in the communities of intervention arms 2 and 4. Only after these communities had commenced building latrines, the health education was launched in the communities of intervention arms 3 and 4 to avoid interference with the methodological approach of the CLTS intervention in arm 4. Preventive chemotherapy was done according to ongoing activities of the national control programme. These activities consist of community-based yearly mass administration of ivermectin and albendazole (against lymphatic filariasis) and yearly administration of praziquantel and albendazole (against schistosomiasis and soil-transmitted helminthiasis) to at-risk groups, adhering to WHO guidelines[5]. Implementation of interventions Community-led total sanitation The CLTS approach is based on participatory rural appraisal that emphasises that the learning effect is considerably higher if knowledge is acquired through self-experience and self-reflexion. Before the intervention, CLTS facilitators were trained and instructed during a 1-week workshop by certified national CLTS facilitators from the Ministry of Sanitation, UNICEF and a Swiss-based nongovernmental organization (FAIRMED; Bern, Switzerland). Communities were contacted, and a first community meeting organised. During this meeting, the ignition process of CLTS was started, which could include the following components according to Kar and Chambers[7]: (i) transect walk (“walk of shame”) through the open defecation areas and water points; (ii) defecation map, mapping of defecation areas and defecation mobility; (iii) identifying the dirtiest neighbourhoods; (iv) calculation of faeces amount and medical expenses; and (v) triggering disgust pathways of faecal contamination (glass of water, faeces to food exercise, flow diagrams of faecal-oral routes, etc.). These components were used to initiate the ignition moment (we are eating each other’s faeces!). When talking about faeces, the term “caca” was employed, as “caca” had been identified as the most suited and culturally accepted term by CLTS facilitators in Côte d’Ivoire. Subsequently, two more steps were pursued that include the identification of natural leaders and the monitoring and sustaining of open defecation-free status or the process towards an open defecation-free community. Although CLTS encourages the communities to build basic sanitary facilities (i.e, latrines), to change one’s hygiene behaviour, and to alter people’s waste disposal practices, it does not impose standard designs and does not provide subsidies. Hence, for toilet construction, most communities used readily available local material, so that toilets were more affordable and accessible for rural communities. When a given community decided to go towards open defecation-free status, an implementation plan of community-based basic sanitation and hygiene services was elaborated. This community was frequently visited by the community development agents to ensure that the implementation of the different actions was done according to protocol. Health education Once communities implementing CLTS were well advanced with the construction of latrines, communities of intervention arms 3 and 4 were visited by the research team, and a first health education session was offered for the entire community. These sessions were informed by results from the preceding focus group discussions (FGDs) of the formative social science research that aimed to identifying knowledge gaps and related key health messages. In each community, interested community members (up to 10) were identified (mostly by the village chief and other village authorities) and invited to form a community health theatre group. In a further visit, the community theatre group received an additional health education session by the team and was coached to develop its own sketch to deliver hygiene and health messages in front of the community. In a final visit, the theatre group presented the sketch to the community, and during this visit, the animated cartoon called “Koko et les lunettes magiques” was screen played to children, although adults were also invited to watch[17]. After the theatre and screening of the cartoon, people were grouped into elderly, adult women, adult men and school-aged children, and discussions about health and hygiene topics were pursued to determine their understanding. Preventive chemotherapy After the baseline cross-sectional survey[15], appropriate treatment was offered to all individuals in the targeted communities, regardless of their infection status and participation in the baseline survey in May/June 2015 (albendazole) and August 2015 (praziquantel). All members of the 56 communities received a single oral dose of albendazole (400 mg for participants aged >2 years and 200 mg for children aged 1–2 years, respectively) against STH. A single 40 mg/kg oral dose of praziquantel against schistosomiasis was administered to community members aged 5 years and above in localities where the prevalence of schistosomiasis was ≥5%, while individual case treatment was applied in localities with lower prevalences. Drug administration was implemented by the national control programme, in collaboration with personnel from local health districts and our research team. These treatments were repeated after follow-up surveys 1 (October 2016) and 2 (December 2017). Outcome measure The primary outcome of the trial was infection status with any soil-transmitted helminth, particularly hookworm infection, as determined by the Kato-Katz method[18]. Secondary outcomes were other parasitic infections (i.e. Schistosoma spp., and intestinal protozoa) and KAPB with regard to hygiene and intestinal parasitic infections. Particular emphasis was placed on hookworm infection because of its endemicity across Côte d’Ivoire and the moderate to high prevalence in the study area[8,12,15]. Parasitological surveys Prior to any intervention, a baseline cross-sectional parasitological survey was conducted in the 56 communities from August to September 2014[15]. The status of infection with helminths and intestinal protozoa was assessed by microscopic examination of stool and urine samples. Follow-up surveys were done 17 months (February 2016) and 38 months (November 2017) after interventions, using the same quality-controlled methods. In each study community, project-associated community health workers (CHWs) provided participants with two plastic containers for stool and urine collection, the day before the field team’s visit. All participating household members were invited to return filled containers the next morning (between 08:00 and 12:00 hours). Stool and urine samples were transferred to laboratories at the general hospitals of Taabo and Djékanou, the community health centre at Kpouèbo, or a mobile field laboratory set up at the dispensary of Léléblé. Participants’ infection status with soil-transmitted helminths ( A. lumbricoides , hookworm and Trichuris trichiura ), Schistosoma mansoni and pathogenic intestinal protozoa ( G. intestinalis and Entamoeba histolytica / E. dispar ), as determined in stool samples, and Schistosoma haematobium , determined in urine samples, were recorded. From each stool sample, duplicate Kato-Katz thick smears were prepared, using a standard template holding 41.7 mg of faeces[18]. The slides were allowed to clear for 30–45 min before examining under a microscope by experienced laboratory technicians. Helminth eggs were counted and recorded for each species separately. A portion of stool (1–2 g) was preserved in 10 ml of sodium acetate-acetic acid-formalin (SAF) solution for further diagnostic work-up. Urine samples that were positive for microhaematuria from reagent strip testing (Hemastix, Siemens Healtheare; Zurich, Switzerland) were subjected to a filtration method for quantification of S. haematobium eggs[19]. SAF-preserved stool samples were transferred to a laboratory at the Université Félix Houphouët-Boigny (Abidjan, Côte d’Ivoire). An ether concentration method was employed and samples examined for helminths and intestinal protozoa by experienced laboratory technicians. The number of species-specific helminth eggs was recorded, whereas intestinal protozoa cysts and trophozoites were recorded semi-quantitatively[20]. For quality control, 10% of the slides were randomly selected and re-examined on the same day by a third technician. In case of conflicting results (negative vs. positive or a difference in the number of egg counts of more than 10%), the slides were re-examined a third time and the results discussed until agreement was reached. The same diagnostic approaches were used for each of the three assessment time points. KAPB questionnaire survey Household’s KAPB were assessed, using a combination of direct observations and interviews using a tablet-based structured questionnaire. All the components of the KAPB study were conducted in parallel to the baseline and follow-up parasitological surveys. It was directed at household heads and included questions on demographic factors (e.g. age, sex, ethnicity and educational attainment), socioeconomic indicators (e.g. possession of household assets) and reported or observed WASH indicators (e.g. sources of water for household use, open defecation, use of latrines and waste disposal in close proximity to the house). In addition, interviewees were asked about their knowledge of health risks associated with open defecation, signs and symptoms of parasitic infections, and how such infections can be prevented and treated. Statistical analysis Parasitological data were double-entered in Microsoft Excel and cross-checked in EpiInfo version 3.5.4 (Centers for Disease Control and Prevention; Atlanta, USA). Questionnaire data were collected using Open Data Kit (ODK; http://opendatakit.org/), operated on mobile Android devices. Data were uploaded daily on a server based at the Swiss Tropical and Public Health Institute (Swiss TPH; Allschwil, Switzerland). Statistical analyses were performed with R version 4.4.1 and STATA version 14.2 (Stata Corporation; College Station, USA). We summarised demographic, socioeconomic characteristics and WASH indicators, prevalence of soil-transmitted helminths, schistosomes and pathogenic intestinal protozoa infections at baseline for each of the four arms separately. For continuous variables (e.g. age) and categorical variables (e.g. prevalence of soil-transmitted helminth infections), we reported means (including standard deviation [SD]) and proportions, respectively. We assessed the effect of the intervention on the occurrence of any soil-transmitted helminth, schistosome and pathogenic intestinal protozoa infections. Our analysis focused on the main effects of the interventions (i.e. CLTS vs non-CLTS and health education vs no health education). To account for the clustered study design, a random effect logistic regression models was used, taking into account the clustering of participants in communities. Effect measures are presented as odds ratios (ORs) and 95% confidence intervals (CIs). The main analysis included only the intervention as fixed effect. The threshold for statistical significance was set at p <0.05. To assess the impact of unsatisfactory intervention adherence, a subgroup analysis was done with communities reaching a minimal latrine coverage of 75% (complier) compared to matching control communities. Results Participation in the study Figure 3 provides an overview of the number of participants who were recruited at baseline, those lost to follow-up and those retained for the final analysis. Study participants were recruited in August and September 2014 in 56 localities in three departments. For the baseline survey, 5,292 participants from 1,267 households were enrolled for the implementation of the study. At the end of this survey, two localities comprising 21 households and 62 participants were not taken into account in the randomisation because no soil-transmitted helminth infection was found. Randomisation took place in 54 localities with 1,246 households including 5,230 participants. Allocations for the interventions were structured as follows: (i) preventive chemotherapy: 14 localities, 300 households, 1,344 participants; (ii) preventive chemotherapy plus CLTS: 13 localities, 312 households, 1,362 participants; (iii) preventive chemotherapy plus health education: 14 localities, 335 households, 1,305 participants; and (iv) all interventions: 13 localities, 299 households, 1,219 participants. Overall, 2084 (39.8%) participants were lost to follow-up at the first and 2740 (52.4%) at the second follow-up survey. Baseline characteristics The demographic and socioeconomic characteristics, WASH indicators, prevalence of soil-transmitted helminth, schistosome and pathogenic intestinal protozoa infections at baseline are summarised in Table 1. Across control and all intervention arms, more than 40% of households had between 6 and 10 individuals. The average number of inhabitants was similar in all arms (9-10 people). On average, 4 people were registered per household to participate in the study. In terms of household occupations, over 90% of households were primarily engaged in subsistence agriculture. Least poor households represented less than 25% of the households interviewed, regardless of the intervention arm. Except for the control arm where 18.6% of households were observed to have piped water (tap water), drinking water coverage rates were below 5% in the intervention arms. The proportions of latrines and their usage rates were: (i) control (20.1%, 16.4%); (ii) CLTS (14.9%, 14.2%); (iii) health education (27.2%, 26.2%); and (iv) CLTS plus health education (21.5%, 18.3%). Open defecation was widely reported (>75%) in control and all intervention arms. Less than 20% of the households in the four groups were not defecating in the open during this assessment. Except for S. mansoni , participants in the four arms were similar in terms of parasitic infection prevalence. Hookworm was the predominant infection (19.9-22.9%), followed by G. intestinalis (12.6-13.4%). Effect of interventions on health outcomes Table 2 provides the results for the primary and secondary outcomes. We observed at the first follow-up 17 months post intervention a prevalence in hookworm infections of 4.3% (69/1594) in the non-CLTS arms compared to 3.8% (59/1552) in the CLTS arms (supplementary table 1). This difference lacked statistical significance (OR 0.87, 95% CI 0.45 to 1.68, p = 0.69). During the second follow up at 38 months post-intervention, we observed a prevalence of 1.9% (24/1278) in the non-CLTS arms compared to 2.1% (26/1212) in the CLTS arms. This difference was not statistically significant (OR 1.15, 95% CI 0.60 to 2.17, p = 0.68). As regards secondary outcomes, we found no statistically significant differences. Adherence to CLTS intervention Figure 4 shows latrine coverage in the study villages at baseline and follow-up survey 1, stratified by study arm. Of the 26 localities in arms 2 and 4, where CLTS had been implemented, 11 had achieved a latrine coverage rate of over 80%. Of these, there were 2 and 4 localities in arms 2 and 4, respectively that achieved 100% coverage. Six and 2 localities in arms 2 and 4, respectively, had coverage rates between 20% and 60%. Low coverage (<20%) was observed in 4 localities, namely one locality in arm 2 and 3 localities in arm 4. No change was recorded in one locality (i.e. Gbamelèkro) of arm 2, as well as in 2 localities (i.e. Ahondo and N’Kloidjo) of arm 4, in terms of latrine coverage (identical latrine rates during both surveys). Effect of interventions on primary and secondary outcomes in adhering communities To better elucidate the effect of interventions, we carried out a subgroup analysis using the 11 communities with the best adherence to the CLTS intervention. Those communities had a latrine coverage at follow-up of at least 75%. We matched those to 11 communities in the non-CLTS arms based on baseline latrine coverage and community size. In this analysis, we found no statistically significant difference in the primary outcome (Table 3). Surprisingly, at follow-up survey 2, we observed a higher prevalence of giardiasis in the CLTS intervention group compared to the control group (14.0% vs 2.5%; OR=6.47, 95% CI: 2.49-16.81; p<0.01) (Table 3). Discussion Preventive chemotherapy, periodically administering anthelminthic drugs to at-risk populations, is the mainstay of morbidity control and might also reduce environmental contamination. However, there is broad understanding that this strategy alone fails to interrupt transmission. An integrated approach with preventive chemotherapy plus WASH interventions and health education has long been advocated as a means of enhancing the control and elimination of helminthiasis and intestinal protozoa infection[ 21 ]. This study was undertaken to assess whether an integrated approach indeed can reduce reinfection patterns of helminths and intestinal protozoa. Our cluster randomised trial conducted in 54 communities in Côte d’Ivoire with a follow-up period of up to 38 months showed no significant impact on reinfection patterns. Through a local participatory approach, CLTS aims at increasing latrine coverage and use and put an end to open defecation and maintain this status within communities[ 8 , 22 , 23 ]. Along with health education that might reinforce CLTS, the two interventions might induce behaviour change. Initially developed as an approach to reduce the incidence of diarrhoea, these interventions also hold promise to prevent infections due to helminths and intestinal protozoa that share transmission routes as infective stages are excreted in human stool (or urine for S. haematobium )[ 7 , 24 ] , [ 25 ]. This study found no evidence that the CLTS intervention (alone or in combination with health education) significantly reduced the incidence of parasitic infections investigated in rural communities compared to standard preventive chemotherapy. Two prior RCTs evaluating a total sanitation programme in India, similarly reported no measurable effect on soil-transmitted helminth post-intervention infection status in the CLTS groups[ 22 , 26 ], while a slight reduction of G. intestinalis infections was noted in the follow-up in rural Madhya Pradesh[ 22 ]. In Indonesia, only weak evidence for A. lumbricoides intensity reduction was found in children from CLTS receiving communities compared to control communities[ 27 ]. Different explanations might explain these observations. The time frame is one. Authors stipulate that to better measure the effect of such interventions on health benefits, long-term research projects should be implemented (i.e. years rather than months)[ 28 , 29 ]. They support their argument by the fact that faecal-oral pathogens cannot disappear in the environment in a short time. In our study, the time frame may have been too short taking into account the observed low transmission pressure of the primary outcome (i.e. soil-transmitted helminth infection) with low prevalence rates observed at both follow-ups in all intervention arms. Related to the potentially too short assessment intervals are the slow uptake of the intervention and low latrine coverage rates. While certain studies implied minimal coverage rates before starting to include measurements to the analysis,[ 26 ] we chose to re-trigger communities with low latrine construction rates and included a second later assessment time point. Yet, we still had quite few communities receiving CLTS remaining under the expected latrine construction goals. A recent study carried out in Ghana (evaluation 10 years after implementation of CLTS) showed that long time frames are necessary to enhance sustainability. This led to a reduction in the number of people not defecating in the open; hence, improvement of sanitation and hygiene, as well as strengthening the application of community rules and regulations regarding WASH[ 30 ]. Another factor is the limited potential of CLTS to “clean” the environment from faecal pathogens. Instead of reducing the risk of infection, unimproved latrine types and construction materials as well as inappropriate use may create new infection sources[ 31 ]. In the CLTS approach subsidies for materials to construct latrines are not foreseen and each community came up with its own model of a basic latrine that was affordable and feasible for it to be built. Lastly also the human behaviour factor remains difficult to be controlled for the perceptibility of actions. Behaviour change needs time and besides inappropriate or inconsistent use of latrines, community members may further continue other risky behaviours that foster faecal-oral transmission of pathogens (e.g. contaminated hands from anal cleansing, no handwashing and food contamination during production, preparation or consumption). Strengths and limitations The design, methods and approach of the study were robust. RCTs offer the greatest potential for causal inference. In order to ensure homogeneous stratification, villages were randomly allocated to different groups (control, intervention) after the baseline survey. This led to similar baseline characteristics and outcome variables (i.e. parasitic infections) across the four arms. Intensified monitoring and evaluation coupled with remobilisation were undertaken to enhance compliance to the CLTS intervention. Our study provides evidence from two follow-up assessments, the later exceeding the time frame of most comparable trials assessing the effect of CLTS intervention on parasitic infections[ 22 , 26 , 27 ]. Although embedded in an RCT, the data generated are close to real-life data, as both the preventive chemotherapy was conducted by the usual actors under their conditions and the CLTS intervention was led by national teams as implemented elsewhere in the country. The limitations of this study come with the complexity of the conduct of a series of different interventions that are executed by a variety of actors and need alignment. Not all interventions always happened in anticipated timeframes and although mitigation strategies and intensified monitoring were put in place, not all receiving communities took up the interventions as planned. Particularly large communities experienced difficulty in adhering to the implementation of the CLTS intervention, and consequently in achieving “open defecation free (ODF)” status. A monitoring system over time could not be put in place after the certification of villages for “ODF” status (post-intervention). In view of this unique and stagnant evaluation of the contamination status with faecal matter and associated pathogens, as well as the lack of environmental analyses, it is not possible to make a definitive appraisal of the true situation. No direct observations of human behaviour were part of this study. Hence, we cannot rule out that community members continued to engage in risky behaviours (e.g. open defecation, not washing hands, unclean food preparation or storage). Another limiting aspect concerns the main study outcome that is infection with any soil-transmitted helminth. Infection rates at the start of the study were relatively low and transmission dynamics appear to be slower than expected in the study area, as reflected by the low reinfection rates in all study arms (including the control arm). These low figures contradicted the hypothesis that communities had returned to their initial prevalence rates at that point in time (i.e. hookworm prevalence > 20%). Our trial was not powered to detect small but from a public health point of view important effects as significant differences. Reassessments in low-to-moderate transmission sites may require longer intervals in-between full intervention uptake and outcome assessment. Additionally, loss to follow-up (40–50%) was higher than anticipated and might have impacted the evaluation of the interventions. To be able to measure an impact on parasitic diseases from integrated interventions, including WASH compared to standard preventive chemotherapy in settings with lower transmission burden, a study with a much longer time frame may be considered. A more rigid evaluation approach to explore environmental contamination status of the communities (also including built latrines and consumed water and food) is recommended to accompany similar future trials. Conclusions Although there were reductions in the prevalence of soil-transmitted helminth infection, in particular hookworm, no statistically significant synergistic effect of the integrative intervention packages compared to standard preventive chemotherapy could be observed during both follow-up surveys. We advocate comprehensive studies that can quantitatively and qualitatively assess the impact of CLTS interventions at the community level over a longer period. As efforts are made to improve coverage of CLTS interventions within rural communities, we emphasise that implementation must be rigorously designed and implemented to achieve the goals of reducing exposure to pathogens and improvement of people’s health and wellbeing. Abbreviations CHW Community Health Worker CI Confidence Interval CLTS Community-Led total Sanitation FGD Focus Group Discussion HDSS Health Demographic Surveillance System ISRCTN International Standard Randomised Controlled Trial Number KAPB Knowledge, Attitudes, Practice and Behaviour ODF Open Defecation Free ODK Open Data Kit OR Odds Ratio RCT Randomised Controlled Trial SAF Sodium acetate-Acetic acid-Formalin SD Standard Deviation STH Soil-Transmitted Helminth UNICEF United Nations Children's Fund WASH Water Sanitation and Hygiene WHO World Health Organisation Declarations Ethics Approval and Consent to Participate Approval of the study protocol was granted by the institutional research commission of the Centre Suisse de Recherches Scientifiques en Côte d’Ivoire (CSRS; Abidjan, Côte d’Ivoire). Ethical clearance for the study was obtained from the Ethics Committee of Basel (EKBB; reference no. 300/13, date of approval: 11 November 2013) and from the ethics committee of the Ministry of Health and Public Hygiene in Côte d’Ivoire (reference no. 76-MSLS-CNER-dkn, date of approval: 28 November 2013). The trial is registered (ISRCTN53102033, date of approval: 26 March 2014 https://www.isrctn.com/ISRCTN53102033). The purpose and procedures of the study were explained to local authorities (village chiefs) and community members. Written informed consent was obtained from all participants (parents/legal guardians signed for children below the age of 18 years). For illiterate participants, impartial witnessers provided signature. Participation was voluntary and withdrawal from the study was possible anytime without further obligations. Moreover, it was mentioned that preventive chemotherapy was provided to all people in the study area, not just those who decide to participate, free of charge through the National Programme for the Control of Neglected Tropical Diseases. Consent for publication Not applicable. Availability of data and materials Data collected for the study, anonymised participant data, and a data dictionary defining each field in the set, will be made available to others on reasonable request. De-identified participant data of the requested dataset plus a data dictionary will be made available on reasonable request immediately following publication for at least 1 year. Access will be granted to researchers who provide a methodologically sound proposal. Principal investigators, and collaborators will approve the proposals on the basis of scientific merit. Requests should be directed to the corresponding author. Researchers requesting data will need to sign a data access agreement before they are granted access. Study protocol is available on study registry page (ISRCTN53102033). Competing interests We declare no competing interests. Funding Funding was provided by UBS Optimus Foundation (Zurich, Switzerland) and the R. Geigy Foundation (Basel, Switzerland). The funders of this study had no role in study design, data collection, data analysis, data interpretation or writing of the paper. Authors’ Contributions Gaoussou Coulibaly (data collection, data management, data analysis and interpretation and writing of first draft); Eveline Hürlimann (data management, data collection, coordination, supervision, critical input to manuscript development); Mamadou Ouattara (coordination, data collection, supervision, quality assurance); Kouassi Dongo (coordination, supervision); Jan Hattendorf (randomisation, data analysis and interpretation, critical input to manuscript development); Fabien Zouzou (intervention conduct and monitoring, coordination, supervision); Fidèle K. Bassa, Richard B. Yapi and Naférima Koné (data collection); Véronique A. Koffi (data collection and data management, conduct of intervention); Clémence Esse (conceptualization and conduct of intervention, data collection, coordination, supervision); Jürg Utzinger (project conceptualization, coordination, supervision, critical review to manuscript); Giovanna Raso (project conceptualization, coordination, supervision, fund raising, reporting, project management); Eliézer K. N’Goran (project conceptualization, supervision, coordination). All authors read and approved the final version of the manuscript. Acknowledgements We thank the Ministry of Sanitation and Drainage of Côte d’Ivoire and the United Nations Children’s Fund (UNICEF) office in Côte d’Ivoire for their authorisation and support. We extend our gratitude for the collaboration and support we received from PNLMTN-CP for the treatment of the communities. We are very grateful to the Community Health Workers (CHW) and CLTS facilitators for their effective contribution in the field. A special mention to the rural communities for their enthusiastic participation. We would like to thank Cyrille K. Konan, Agodio Loukouri, Nabélékounon Tuo, N’Tamon N. Roméo, Ambroise Apala, Honorine Moro, Stéphane Y. Babo and the Taabo HDSS team for their invaluable commitment to collect data. The authors express their gratitude to the laboratory technicians, namely: Laurent K. Lohourignon (Rest In Peace, 13 march 2025), Arthur Anzara, Mamadou Traoré (Mister Tee), Salia Diabaté, Séraphin Kouadio, Raphaël G. Diabré (Paco), Valian Kouadio, Gauthier Meledge their contribution to the quality of the data collected. References Wong LW, Ong KS, Khoo JR, Goh CBS, Hor JW, Lee SM. Human intestinal parasitic infection: a narrative review on global prevalence and epidemiological insights on preventive, therapeutic and diagnostic strategies for future perspectives. 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Baseline characteristics of included households in terms of population, occupation, Water, Sanitation and Hygiene (WASH) indicators and parasitic infection prevalence by randomized intervention group Control Interventions Characteristics CLTS CHEP CLTS+CHEP N Mean (SD) or Percent N Mean (SD) or Percent N Mean (SD) or Percent N Mean (SD) or Percent Household characteristics Number of enrolled households 300 312 335 299 Number of enrolled children per household Age <5 years 0.5 (0.6) 0.3 (0.5) 0.3 (0.5) 0.4 (0.5) Age 5-15 years 3.1 (1.9) 3.2 (2.1) 2.8 (1.7) 3.0 (2.0) Number of enrolled adolescents and adults per households 0.8 (0.4) 0.8 (0.4) 0.8 (0.4) 0.7 (0.4) Number of participants per households 4.5 (2.0) 4.4 (2.3) 3.9 (1.9) 4.1 (2.2) Demography N. household questionnaire 274 288 294 251 ≤5 people 44 16.1% 62 21.5% 61 20.8% 52 20.7% 6-10 people 126 46.0% 125 43.4% 145 49.3% 116 46.2% >10 people 104 38.0% 101 35.1% 88 29.9% 83 33.1% Number of people per household 9.9 (5.0) 10.0 (6.0) 9.4 (5.3) 10.3 (6.8) Activities Agriculture 247 90.1% 266 92.4% 266 90.5% 233 92.8% Fishing 6 2.2% 10 3.5% 15 5.1% 5 2.0% Other occupations* 21 7.7% 12 4.1% 13 4.4% 13 5.2% Wealth quartiles Most poor 63 23.0% 87 30.2% 86 29.3% 93 37.1% Very poor 68 24.8% 75 26.1% 65 22.1% 55 21.9% Poor 79 28.8% 56 19.4% 75 25.5% 47 18.7% Least poor 64 23.4% 70 24.3% 68 23.1% 56 22.3% Water, Sanitation and Hygiene (WASH) indicators Households with tap water 51 18.6% 1 0.3% 0 0.0% 12 4.8% Other sources of water for households** 223 81.4% 287 99.7% 294 100% 239 95.2% Households with latrines 55 20.1% 43 14.9% 80 27.2% 54 21.5% Use of latrines by households Never 216 78.8% 243 84.4% 207 70.4% 202 80.5% Rarely 7 2.6% 1 0.3% 5 1.7% 2 0.8% Often 6 2.2% 3 1.0% 5 1.7% 1 0.4% Always 45 16.4% 41 14.2% 77 26.2% 46 18.3% Practice of open defecation by households 227 82.8% 220 76.7% 233 79.3% 192 76.8% Defecation in plantation/field Never 36 13.1% 32 11.1% 48 16.3% 21 8.4% Rarely 29 10.6% 40 13.9% 41 13.9% 29 11.6% Often 114 41.6% 146 50.7% 149 50.7% 112 44.6% Always 95 34.7% 55 19.1% 56 19.1% 89 35.5% Individual characteristics Demography N 1344 1362 1305 1219 Sex (Number of individuals /Number of participants ) Male 686 51.0% 676 49.6% 645 49.4% 610 50.0% Female 658 49.0% 686 50.4% 660 50.6% 609 50.0% Age (Number of individuals/Number of participants ) 15 years 254 18.9% 256 18.8% 264 20.2% 210 17,2% Parasitic infections Number individuals with KK result 1289 1290 1212 1194 Hookworm 281 21.8% 273 21.2% 277 22.9% 238 19.9% Trichuris trichiura 28 2.2% 18 1.4% 24 2.0% 22 1.8% Ascaris lumbricoides 6 0.5% 2 0.2% 3 0.2% 5 0.4% Schistosoma mansoni 4 0.3% 22 1.7% 87 7.2% 37 3.1% Number individuals with UF result 1336 1348 1294 1203 Schistosoma haematobium 52 3.9% 54 4.0% 43 3.3% 29 2.4% Number individuals with ECM result 1228 1227 1149 1120 Giardia lamblia 157 12.8% 164 13.4% 145 12.6% 141 12.6% Entamoeba histolytica/dispar 75 6.1% 65 5.3% 75 6.5% 60 5.4% Abbreviations: PC, Preventive chemotherapy; CLTS, Community-led total sanitation; CHEP, Community health education program; SD, Standard deviation, KK, Kato-katz; UF, Urine filtration, ECM, Ether-concentration method * Other occupations include: housewife, trader, teacher, animal breeder ** Other sources of water include : Drilling/pump, well, river/backwater/pond Table 2. Effect of the intervention on primary and secondary outcomes CLTS Yes vs No OR (95% CI) Control CLTS CHEP CLTS+CHEP P-value n FU1 (by diagnostic approach) 879*|922"|868^ 882*|916"|873^ 715*|783|707^ 670*|696"|662^ n FU2 (by diagnostic approach) 689*|757"|689^ 659*|721"|653^ 589*|662"|587^ 553*|606"|552^ Primary outcome (STH infection status)* Hookworm FU1 39 (4.4) 29 (3.3) 30 (4.2) 30 (4.5) 0.87 (0.45-1.62) 0.69 Hookworm FU2 15 (2.2) 10 (1.5) 9 (1.5) 16 (2.9) 1.14 (0.60-2.17) 0.68 Trichuris trichiura FU1 7 (0.8) 6 (0.7) 9 (1.3) 5 (0.7) ND Trichuris trichiura FU2 3 (0.4) 0 (0.0) 0 (0.0) 3 (0.5) ND Ascaris lumbricoides FU1 1 (0.1)) 0 (0.0) 1 (0.1) 3 (0.4) ND Ascaris lumbricoides FU2 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) ND Secondary outcome ( Schistosoma spp . & intestinal protozoa infection status) Schistosoma spp . Schistosoma mansoni FU1* 2 (0.2) 5 (0.6) 23 (3.2) 23 (3.4) 1.15 (0.20-6.79) 0.87 Schistosoma mansoni FU2* 0 (0.0) 6 (0.9) 32 (5.4) 15 (2.7) 0.69 (0.08-5.80) 0.73 Schistosoma haematobium FU1" 13 (1.5) 16 (1.8) 14 (2,0) 26 (3.9) 1.66 (0.48-5.77) 0.42 Schistosoma haematobium FU2" 32 (4.2) 16 (2.2) 19 (2.9) 7 (1.2) 0.47 (0.10-2.28) 0.35 Intestinal protozoa^ Giardia lamblia FU1 41 (4.7) 51 (5.8) 22 (3.1) 30 (4.5) 1.34 (0.84-2.14) 0.22 Giardia lamblia FU2 67 (9.2) 79 (12.1) 54 (9.2) 64 (11.6) 1.29 (0.96-1.73) 0.10 Entamoeba histolytica FU1 23 (2.6) 22 (2.5) 18 (2.5) 16 (2.4) 0.95 (0.51-1.76) 0.87 Entamoeba histolytica FU2 49 (7.1) 34 (5.2) 40 (6.8) 41 (7.4) 0.89 (0.67-1.17) 0.39 PC, Preventive chemotherapy; CLTS, Community-led total sanitation; CHEP, Community health education program; FU, Follow-up; STH, Soil-transmitted helminth; ND, Not determined Diagnostic approaches: * Kato-katz; "Urine filtration; ^Ether-concentration method Table 3. Effect of the intervention on primary and secondary outcomes using complier matching for 11 localities in each CLTS (latrine coverage>75%) and no-CLTS CLTS Yes vs No OR (95% CI) no-CLTS CLTS P-value n FU1 (by diagnostic approach) 305*|332"|304^ 361*|372"|356^ n FU2 (by diagnostic approach) 239*|273"|238^ 293*|318"|293^ Primary outcome (STH infection status)* Hookworm FU1 11 (3.6) 26 (7.2) 2.07 (0.72-5.96) 0.18 Hookworm FU2 4 (1.7) 13 (4.4) 2.72 (0.76-9.76) 0.12 Trichuris trichiura FU1 5 (1.6) 5 (1.4) ND Trichuris trichiura FU2 0 (0.0) 2 (0.7) ND Ascaris lumbricoides FU1 2 (0.7) 0 (0.0) ND Ascaris lumbricoides FU2 0 (0.0) 0 (0.0) ND Secondary outcome ( Schistosoma spp . & intestinal protozoa infection status) Schistosoma spp. Schistosoma mansoni FU1* 1 (0.3) 1 (0.3) ND Schistosoma mansoni FU2* 0 (0.0) 1 (0.3) ND Schistosoma haematobium FU1" 9 (2.7) 2 (0.5) ND Schistosoma haematobium FU2" 11 (4.0) 2 (0.6) ND Intestinal protozoa^ Giardia lamblia FU1 14 (4.6) 16 (4.5) 0.97 (0.42-2.26) 0.95 Giardia lamblia FU2 6 (2.5) 41 (14.0) 6.47 (2.49-16.81) <0.01 Entamoeba histolytica FU1 9 (3.0) 11 (3.1) 2.07 (0.72-5.96) 0.18 Entamoeba histolytica FU2 11 (4.6) 23 (7.8) 2.73 (0.76-9.76) 0.12 CLTS, Community-led total sanitation; FU, Follow-up; STH, Soil-transmitted helminth; ND, Not determined Diagnostic approaches: * Kato-katz; "Urine filtration; ^Ether-concentration method Additional Declarations No competing interests reported. Supplementary Files Additionalfile1CONSORT2025checklist.docx Additionalfile2StudyProtocolRasoetalJRP2018.pdf Additionalfile3studyrecordISRCTN5310203320210304.pdf Supplementarytable1.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 03 May, 2026 Reviewers agreed at journal 20 Apr, 2026 Reviewers invited by journal 09 Apr, 2026 Editor assigned by journal 23 Mar, 2026 Submission checks completed at journal 23 Mar, 2026 First submitted to journal 22 Mar, 2026 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. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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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-9191647","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":621883377,"identity":"d2b02d7a-1c67-41e5-8f32-193105a54bfb","order_by":0,"name":"Gaoussou Coulibaly","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA6ElEQVRIiWNgGAWjYDADAzBZAWVUEK/lDJRxhmgtjG1EaJF3P3xM8scfm8Tt0oefSfycd1jenL35AMPBPbi1GJ5JS5PmbUtL3NmXZibZu+2w4c6eYwkMB57h0dKQYybN2HA4ccMZBmMD3m2HGTfcyDFg/nAAj5b+N2ZAh4G0sH82/DvnsD1IC8MBPFrkJXLMJHjYQFp4DB/zgqwjpMVA4lmyNdAvxjt7eAofyxxLT95w5ljCAby29CcfvAkMMdntPOwbDr6psbbdcLz54AO8tqDJNYNJPBqAtjSg8uvwKR4Fo2AUjIIRCgDpCl0rwshqpAAAAABJRU5ErkJggg==","orcid":"","institution":"Université Félix Houphouët-Boigny","correspondingAuthor":true,"prefix":"","firstName":"Gaoussou","middleName":"","lastName":"Coulibaly","suffix":""},{"id":621883381,"identity":"08f79c97-4c9b-4f1a-bc6f-46162d7e86ee","order_by":1,"name":"Eveline Hürlimann","email":"","orcid":"","institution":"Swiss Tropical and Public Health Institute","correspondingAuthor":false,"prefix":"","firstName":"Eveline","middleName":"","lastName":"Hürlimann","suffix":""},{"id":621883388,"identity":"bc4b1457-53a0-43d5-b7f2-62e4f130dfe4","order_by":2,"name":"Mamadou Ouattara","email":"","orcid":"","institution":"Université Félix Houphouët-Boigny","correspondingAuthor":false,"prefix":"","firstName":"Mamadou","middleName":"","lastName":"Ouattara","suffix":""},{"id":621883390,"identity":"affa44fe-c081-449e-b574-165e7da46d07","order_by":3,"name":"Dongo Kouassi","email":"","orcid":"","institution":"Université Félix Houphouët-Boigny","correspondingAuthor":false,"prefix":"","firstName":"Dongo","middleName":"","lastName":"Kouassi","suffix":""},{"id":621883404,"identity":"1e267544-a0a7-4c37-8145-0e9b4fcc81a0","order_by":4,"name":"Jan Hattendorf","email":"","orcid":"","institution":"Swiss Tropical and Public Health Institute","correspondingAuthor":false,"prefix":"","firstName":"Jan","middleName":"","lastName":"Hattendorf","suffix":""},{"id":621883409,"identity":"eb863a54-cabe-4a48-a919-a5b20f61ae54","order_by":5,"name":"Fabien Zouzou","email":"","orcid":"","institution":"Fairmed","correspondingAuthor":false,"prefix":"","firstName":"Fabien","middleName":"","lastName":"Zouzou","suffix":""},{"id":621883413,"identity":"58483a4f-113b-4ec8-8eb0-e8b13c913b04","order_by":6,"name":"Fidèle K. 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Koffi","email":"","orcid":"","institution":"Université Alassane Ouattara","correspondingAuthor":false,"prefix":"","firstName":"Véronique","middleName":"A.","lastName":"Koffi","suffix":""},{"id":621883423,"identity":"427205cd-034d-4214-b9b8-a13bfd6b31b5","order_by":10,"name":"Clémence Essé","email":"","orcid":"","institution":"Université Félix Houphouët-Boigny","correspondingAuthor":false,"prefix":"","firstName":"Clémence","middleName":"","lastName":"Essé","suffix":""},{"id":621883427,"identity":"f80741cf-84b0-449f-948f-25436386fe23","order_by":11,"name":"Jürg Utzinger","email":"","orcid":"","institution":"Swiss Tropical and Public Health Institute","correspondingAuthor":false,"prefix":"","firstName":"Jürg","middleName":"","lastName":"Utzinger","suffix":""},{"id":621883434,"identity":"5d6f3114-5cea-4f95-8221-6378e568715e","order_by":12,"name":"Giovanna Raso","email":"","orcid":"","institution":"Health Promotion Switzerland","correspondingAuthor":false,"prefix":"","firstName":"Giovanna","middleName":"","lastName":"Raso","suffix":""},{"id":621883436,"identity":"c7cd1e20-6791-4b70-b737-f654d638b4f8","order_by":13,"name":"Eliézer K. N’Goran","email":"","orcid":"","institution":"Université Félix Houphouët-Boigny","correspondingAuthor":false,"prefix":"","firstName":"Eliézer","middleName":"K.","lastName":"N’Goran","suffix":""}],"badges":[],"createdAt":"2026-03-22 13:53:04","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9191647/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9191647/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":107254628,"identity":"7da13def-179b-40b1-905c-5c0caf50f70d","added_by":"auto","created_at":"2026-04-19 12:04:21","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":60976,"visible":true,"origin":"","legend":"\u003cp\u003eMap displaying randomization in three departments for trial implementation, south-central, Côte d’Ivoire\u003c/p\u003e\n\u003cp\u003ePC, Preventive chemotherapy; CLTS, Community-led total sanitation; CHEP, Community health education program\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-9191647/v1/3f3ab0b0a63d24f1195a8b8e.png"},{"id":107484528,"identity":"0b704155-7921-4f52-904d-7926172fc532","added_by":"auto","created_at":"2026-04-22 02:32:19","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":51484,"visible":true,"origin":"","legend":"\u003cp\u003eOverview of the trial activities, from August 2014 to November 2017, south-central, Côte d’Ivoire\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eKAPB,\u003c/strong\u003e \u003cstrong\u003eKnowledge–attitudes-practices and beliefs;\u0026nbsp; CLTS, Community-led total sanitation; CHEP, Community health education program; IVM, Ivermectin; ALB, Albendazole; PZQ, Praziquantel; M\u0026amp;E, Monitoring and evaluation; ODF, Open Defecation Free; 1st Certification; First certification; REMOB, Remobilisation; 2\u003c/strong\u003e\u003csup\u003e\u003cstrong\u003end\u003c/strong\u003e\u003c/sup\u003e\u003cstrong\u003e Cert., Second certification\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-9191647/v1/59174685e2b1b50a93eeb350.png"},{"id":107254631,"identity":"377a1ab3-adfd-42b9-ad12-5329a6aea70a","added_by":"auto","created_at":"2026-04-19 12:04:22","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":44379,"visible":true,"origin":"","legend":"\u003cp\u003eTrial profile: enrollment, intervention allocation, and participation in baseline and follow-up surveys\u003c/p\u003e\n\u003cp\u003e\u003csup\u003ea\u003c/sup\u003e number of enrolled participants with parasitological assessment at baseline\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-9191647/v1/c9f8be25b199c90f64d49383.png"},{"id":107254632,"identity":"08045cbd-915d-4b7d-a1f4-d18bf9f3b279","added_by":"auto","created_at":"2026-04-19 12:04:22","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":148931,"visible":true,"origin":"","legend":"\u003cp\u003eLatrine coverage in 54 study communities at follow-up 1, February 2016, south central Côte d’Ivoire, Symbol size is proportional to village population.\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-9191647/v1/99dc81b3cd36da2f8a043346.png"},{"id":109067446,"identity":"e443e9fd-8337-40a7-9cde-01d1ec494470","added_by":"auto","created_at":"2026-05-12 09:52:20","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":939191,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9191647/v1/8bb97741-4e01-4f18-a168-a6942a2c1e28.pdf"},{"id":107254629,"identity":"f7b4008c-9d73-4276-b586-751e2bb947e8","added_by":"auto","created_at":"2026-04-19 12:04:21","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":40923,"visible":true,"origin":"","legend":"","description":"","filename":"Additionalfile1CONSORT2025checklist.docx","url":"https://assets-eu.researchsquare.com/files/rs-9191647/v1/bf074b0742ca12d302ac4cdc.docx"},{"id":107254635,"identity":"add18378-effe-4527-aa05-733a106fb8ea","added_by":"auto","created_at":"2026-04-19 12:04:22","extension":"pdf","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":1027453,"visible":true,"origin":"","legend":"","description":"","filename":"Additionalfile2StudyProtocolRasoetalJRP2018.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9191647/v1/299737dfb1243348b214fe73.pdf"},{"id":107254634,"identity":"20cd5763-b68a-4d2e-9171-47869f2e505c","added_by":"auto","created_at":"2026-04-19 12:04:22","extension":"pdf","order_by":3,"title":"","display":"","copyAsset":false,"role":"supplement","size":39078,"visible":true,"origin":"","legend":"","description":"","filename":"Additionalfile3studyrecordISRCTN5310203320210304.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9191647/v1/303db52244cb5aa096e159be.pdf"},{"id":107254633,"identity":"d5b0e558-36c7-4dfd-92bb-1ae8fefdc99e","added_by":"auto","created_at":"2026-04-19 12:04:22","extension":"docx","order_by":4,"title":"","display":"","copyAsset":false,"role":"supplement","size":15826,"visible":true,"origin":"","legend":"","description":"","filename":"Supplementarytable1.docx","url":"https://assets-eu.researchsquare.com/files/rs-9191647/v1/7b16c46183327d7fd44c6ae1.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Effectiveness of community-led total sanitation and health education against helminth infections in Côte d’Ivoire: a cluster-randomised factorial trial with 38 months of follow-up","fulltext":[{"header":"Background","content":"\u003cp\u003eParasitic infections are common, particularly in resource-limited setting, where personal hygiene and access to clean water and sanitation (safe disposal of human faeces and urine) is often poor[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. It is estimated that more than a billion people are affected by soil-transmitted helminthiasis (STH), schistosomiasis and intestinal protozoa infections (e.g. amoebiasis and giardiasis), causing an estimated 3.5\u0026nbsp;million disability-adjusted life years[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe global control strategy for helminthiasis is preventive chemotherapy through regular administration of deworming drugs to entire populations at risk. Albendazole or mebendazole against soil-transmitted helminthiasis and praziquantel against schistosomiasis are the current drugs of choice[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. However, preventive chemotherapy does not protect patients from reinfections[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. The optimal strategy to control the transmission of these diseases is based on three pillars: (i) large-scale deworming to gradually reduce the infection burden; (ii) improved water, sanitation and hygiene (WASH) to reduce environmental contamination with infectious stages; and (iii) health education to alter behaviour to reduce environmental contamination and risk of infection. Integrated approaches combining several pillars of control hold promise for improving the cost-effectiveness of interventions and thus ensuring the sustainability of control activities in resource-constrained settings.\u003c/p\u003e \u003cp\u003eCommunity-led total sanitation (CLTS) represents a participatory approach that has been developed as a strategy to reduce the incidence of diarrhoea and intestinal infections by putting an end to open defecation and maintaining this status within communities[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. In a pilot study carried out in the Taabo health and demographic surveillance system (HDSS) in C\u0026ocirc;te d\u0026rsquo;Ivoire, the impact on parasitic infections and attitudes and practices towards WASH of an intervention package, including CLTS and health education, was tested in nine communities within the Taabo HDSS between 2011 and 2012[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Promising effects on hookworm prevalence and intensity as well as lower follow-up infection rates with intestinal protozoa in communities receiving the intervention were observed. However, this study was conducted at small scale and was limited by its design, as it lacked a randomised controlled trial set-up to address potential baseline discrepancies between group assignments and a short interval between baseline and follow-up assessment.\u003c/p\u003e \u003cp\u003eIn August 2013, a project was launched in 56 communities in the south-central part of C\u0026ocirc;te d\u0026rsquo;Ivoire with the aim to assess and quantify the effect of preventive chemotherapy, combined with either CLTS, or health education, or both measures combined, on reinfection with soil-transmitted helminths, schistosomes and intestinal protozoa, using a cluster randomised controlled trial (RCT) design[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Additionally, the effect of the interventions on the incidence of diarrhoea was determined. Here we present the impact data on the parasitic infections that were assessed at three different timepoints during the overall trial duration of 38 months.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy area and population\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was implemented in 56 communities in three departments in the south-central part of C\u0026ocirc;te d\u0026rsquo;Ivoire (i.e. Taabo, Dj\u0026eacute;kanou and Toumodi). People are mainly engaged in subsistence agriculture, whereas rubber, cocoa and coffee are farmed as cash crops.\u003c/p\u003e\n\u003cp\u003eInitially, the study was planned to comprise 56 localities in the department of Taabo alone, because of the presence of an HDSS that monitored a population of about 42,000 people when the trial was launched[10]. However, the number of appropriately sized communities according to implementation of CLTS in the Taabo department was lower than expected, and hence, the study was extended into the adjacent departments of Dj\u0026eacute;kanou and Toumodi to obtain the required number of localities. To that end, our study involved 40 localities in Taabo, nine in Dj\u0026eacute;kanou and seven in Toumodi.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFactorial cluster randomised trial design\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eRandomisation occurred after baseline data collection was completed. Sample size calculation was done using the Web-based sample calculator for cluster randomised trials presented elsewhere[11],\u0026nbsp;assuming a baseline hookworm prevalence of 30% according to previous studies in the region[12,13], a prevalence reduction of 50% after implementation of interventions[8], an intra-cluster correlation of 0.4. The high correlation within the community was assumed because of the participatory nature of the interventions. Assuming a dropout rate of 30% at each follow-up we estimated that 40 clusters with 152 individuals per cluster are required to achieve 80% power at the 5% significance level. In C\u0026ocirc;te d\u0026rsquo;Ivoire, the average number of people per household in the study area is 7[12]\u0026nbsp;(our assumption was 2 adults and 5 children). For a sample size of 152 children per community, we therefore included 30 households per community.\u003c/p\u003e\n\u003cp\u003eThe communities were selected based on their population size. We intended to include communities with at least 30 households and a population size not exceeding 600 individuals because this is the optimal recommended size for implementation of the CLTS intervention[7]. Given the demographic characteristics of the study area, somewhat smaller communities (slightly less than 30 households) and villages exceeding 600 individuals were also included. The selection of up to 30 households per community was done at random, according to the World Health Organization\u0026rsquo;s (WHO) Expanded Programme on Immunization (EPI) method[14]. Our main target group were children aged 5-15 years, on whom sample size calculation was based. Additionally, whenever possible, 1 pre-school-aged child (\u0026lt;5 years) and 1 adolescent or adult (\u0026gt;15 years) from each household were also selected.\u0026nbsp;All the 3 categories of participants underwent parasitological examinations. Household heads (or their spouses/partners) were administered a questionnaire for knowledge, attitudes, practices and beliefs (KAPB), whereas direct observations in each household were done to check for the presence, use and maintenance of latrines as well as potential open defecation and waste disposal sites in close proximity. The trial communities were assigned by restricted randomisation to 1 of 4 intervention arms with 14 communities per intervention arm based on baseline hookworm (the most prominent soil-transmitted helminth species identified in the area) prevalence and population size[15,16]. The control and 3 intervention arms are as follows: (i) control arm; (ii) CLTS; (iii) health education; and (iv) CLTS and health education, resulting in a 2\u0026thinsp;\u0026times;\u0026thinsp;2 factorial design. In addition, all villages received annual preventive chemotherapy.\u003c/p\u003e\n\u003cp\u003eFigure 1\u0026nbsp;shows the study area with the 56 selected communities, stratified by study arm. Interventions started right after randomisation of the communities.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAssessments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA first follow-up parasitological and KAPB questionnaire survey was carried out 17 months after the baseline cross-sectional survey. A second follow-up survey was scheduled another 21 months later. At the end of the CLTS intervention, the communities were visited and inspected using standardised forms. Transects were done to assess whether open defecation and waste disposal spots were visible and all households were inspected for the availability of latrines. An overview of the activities during the study (from August 2014 to November 2017) is provided in Figure 2.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInterventions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe interventions were implemented after the baseline cross-sectional survey[15]. The CLTS intervention was started in the communities of intervention arms 2 and 4. Only after these communities had commenced building latrines, the health education was launched in the communities of intervention arms 3 and 4 to avoid interference with the methodological approach of the CLTS intervention in arm 4. Preventive chemotherapy was done according to ongoing activities of the national control programme. These activities consist of community-based yearly mass administration of ivermectin and albendazole (against lymphatic filariasis) and yearly administration of praziquantel and albendazole (against schistosomiasis and soil-transmitted helminthiasis) to at-risk groups, adhering to WHO guidelines[5].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eImplementation of interventions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eCommunity-led total sanitation\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe CLTS approach is based on participatory rural appraisal that emphasises that the learning effect is considerably higher if knowledge is acquired through self-experience and self-reflexion. Before the intervention, CLTS facilitators were trained and instructed during a 1-week workshop by certified national CLTS facilitators from the Ministry of Sanitation, UNICEF and a Swiss-based nongovernmental organization (FAIRMED; Bern, Switzerland). Communities were contacted, and a first community meeting organised. During this meeting, the ignition process of CLTS was started, which could include the following components according to Kar and Chambers[7]:\u0026nbsp;(i) transect walk (\u0026ldquo;walk of shame\u0026rdquo;) through the open defecation areas and water points; (ii) defecation map, mapping of defecation areas and defecation mobility; (iii) identifying the dirtiest neighbourhoods; (iv) calculation of faeces amount and medical expenses; and (v) triggering disgust pathways of faecal contamination (glass of water, faeces to food exercise, flow diagrams of faecal-oral routes, etc.). These components were used to initiate the ignition moment (we are eating each other\u0026rsquo;s faeces!). When talking about faeces, the term \u0026ldquo;caca\u0026rdquo; was employed, as \u0026ldquo;caca\u0026rdquo; had been identified as the most suited and culturally accepted term by CLTS facilitators in C\u0026ocirc;te d\u0026rsquo;Ivoire. Subsequently, two more steps were pursued that include the identification of natural leaders and the monitoring and sustaining of open defecation-free status or the process towards an open defecation-free community. Although CLTS encourages the communities to build basic sanitary facilities (i.e, latrines), to change one\u0026rsquo;s hygiene behaviour, and to alter people\u0026rsquo;s waste disposal practices, it does not impose standard designs and does not provide subsidies. Hence, for toilet construction, most communities used readily available local material, so that toilets were more affordable and accessible for rural communities. When a given community decided to go towards open defecation-free status, an implementation plan of community-based basic sanitation and hygiene services was elaborated. This community was frequently visited by the community development agents to ensure that the implementation of the different actions was done according to protocol.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eHealth education\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOnce communities implementing CLTS were well advanced with the construction of latrines, communities of intervention arms 3 and 4 were visited by the research team, and a first health education session was offered for the entire community. These sessions were informed by results from the preceding focus group discussions (FGDs) of the formative social science research that aimed to identifying knowledge gaps and related key health messages. In each community, interested community members (up to 10) were identified (mostly by the village chief and other village authorities) and invited to form a community health theatre group. In a further visit, the community theatre group received an additional health education session by the team and was coached to develop its own sketch to deliver hygiene and health messages in front of the community. In a final visit, the theatre group presented the sketch to the community, and during this visit, the animated cartoon called \u0026ldquo;Koko et les lunettes magiques\u0026rdquo; was screen played to children, although adults were also invited to watch[17]. After the theatre and screening of the cartoon, people were grouped into elderly, adult women, adult men and school-aged children, and discussions about health and hygiene topics were pursued to determine their understanding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003ePreventive chemotherapy\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAfter the baseline cross-sectional survey[15], appropriate treatment was offered to all individuals in the targeted communities, regardless of their infection status and participation in the baseline survey in May/June 2015 (albendazole) and August 2015 (praziquantel). All members of the 56 communities received a single oral dose of albendazole (400 mg for participants aged \u0026gt;2 years and 200 mg for children aged 1\u0026ndash;2 years, respectively) against STH. A single 40 mg/kg oral dose of praziquantel against schistosomiasis was administered to community members aged 5 years and above in localities where the prevalence of schistosomiasis was \u0026ge;5%, while individual case treatment was applied in localities with lower prevalences. Drug administration was implemented by the national control programme, in collaboration with personnel from local health districts and our research team. These treatments were repeated after follow-up surveys 1 (October 2016) and 2 (December 2017).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOutcome measure\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe primary outcome of the trial was infection status with any soil-transmitted helminth, particularly hookworm infection, as determined by the Kato-Katz method[18]. Secondary outcomes were other parasitic infections (i.e. \u003cem\u003eSchistosoma\u0026nbsp;\u003c/em\u003espp., and intestinal protozoa) and KAPB with regard to hygiene and intestinal parasitic infections. Particular emphasis was placed on hookworm infection because of its endemicity across C\u0026ocirc;te d\u0026rsquo;Ivoire and the moderate to high prevalence in the study area[8,12,15].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eParasitological surveys\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePrior to any intervention, a baseline cross-sectional parasitological survey was conducted in the 56 communities from August to September 2014[15]. The status of infection with helminths and intestinal protozoa was assessed by microscopic examination of stool and urine samples. Follow-up surveys were done 17 months (February 2016) and 38 months (November 2017) after interventions, using the same quality-controlled methods.\u003c/p\u003e\n\u003cp\u003eIn each study community, project-associated community health workers (CHWs) provided participants with two plastic containers for stool and urine collection, the day before the field team\u0026rsquo;s visit. All participating household members were invited to return filled containers the next morning (between 08:00 and 12:00 hours). Stool and urine samples were transferred to laboratories at the general hospitals of Taabo and Dj\u0026eacute;kanou, the community health centre at Kpou\u0026egrave;bo, or a mobile field laboratory set up at the dispensary of L\u0026eacute;l\u0026eacute;bl\u0026eacute;.\u003c/p\u003e\n\u003cp\u003eParticipants\u0026rsquo; infection status with soil-transmitted helminths (\u003cem\u003eA.\u0026nbsp;lumbricoides\u003c/em\u003e, hookworm and \u003cem\u003eTrichuris trichiura\u003c/em\u003e), \u003cem\u003eSchistosoma mansoni\u003c/em\u003e and pathogenic intestinal protozoa (\u003cem\u003eG.\u0026nbsp;intestinalis\u003c/em\u003e and \u003cem\u003eEntamoeba histolytica\u003c/em\u003e/\u003cem\u003eE.\u0026nbsp;dispar\u003c/em\u003e), as determined in stool samples, and \u003cem\u003eSchistosoma haematobium\u003c/em\u003e, determined in urine samples, were recorded. From each stool sample, duplicate Kato-Katz thick smears were prepared, using a standard template holding 41.7 mg of faeces[18]. The slides were allowed to clear for 30\u0026ndash;45 min before examining under a microscope by experienced laboratory technicians. Helminth eggs were counted and recorded for each species separately. A portion of stool (1\u0026ndash;2 g) was preserved in 10 ml of sodium acetate-acetic acid-formalin (SAF) solution for further diagnostic work-up. Urine samples that were positive for microhaematuria from reagent strip testing (Hemastix, Siemens Healtheare; Zurich, Switzerland) were subjected to a filtration method for quantification of \u003cem\u003eS.\u0026nbsp;haematobium\u003c/em\u003e eggs[19].\u003c/p\u003e\n\u003cp\u003eSAF-preserved stool samples were transferred to a laboratory at the Universit\u0026eacute; F\u0026eacute;lix Houphou\u0026euml;t-Boigny (Abidjan, C\u0026ocirc;te d\u0026rsquo;Ivoire). An ether concentration method was employed and samples examined for helminths and intestinal protozoa by experienced laboratory technicians. The number of species-specific helminth eggs was recorded, whereas intestinal protozoa cysts and trophozoites were recorded semi-quantitatively[20].\u003c/p\u003e\n\u003cp\u003eFor quality control, 10% of the slides were randomly selected and re-examined on the same day by a third technician. In case of conflicting results (negative vs. positive or a difference in the number of egg counts of more than 10%), the slides were re-examined a third time and the results discussed until agreement was reached.\u003c/p\u003e\n\u003cp\u003eThe same diagnostic approaches were used for each of the three assessment time points.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eKAPB questionnaire survey\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eHousehold\u0026rsquo;s KAPB were assessed, using a combination of direct observations and interviews using a tablet-based structured questionnaire. All the components of the KAPB study were conducted in parallel to the baseline and follow-up parasitological surveys. It was directed at household heads and included questions on demographic factors (e.g. age, sex, ethnicity and educational attainment), socioeconomic indicators (e.g. possession of household assets) and reported or observed WASH indicators (e.g. sources of water for household use, open defecation, use of latrines and waste disposal in close proximity to the house). In addition, interviewees were asked about their knowledge of health risks associated with open defecation, signs and symptoms of parasitic infections, and how such infections can be prevented and treated.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParasitological data were double-entered in Microsoft Excel and cross-checked in EpiInfo version 3.5.4 (Centers for Disease Control and Prevention; Atlanta, USA). Questionnaire data were collected using Open Data Kit (ODK; http://opendatakit.org/), operated on mobile Android devices. Data were uploaded daily on a server based at the Swiss Tropical and Public Health Institute (Swiss TPH; Allschwil, Switzerland). Statistical analyses were performed with R version 4.4.1 and STATA version 14.2 (Stata Corporation; College Station, USA).\u003c/p\u003e\n\u003cp\u003eWe summarised demographic, socioeconomic characteristics and WASH indicators, prevalence of soil-transmitted helminths, schistosomes and pathogenic intestinal protozoa infections at baseline for each of the four arms separately. For continuous variables (e.g. age) and categorical variables (e.g. prevalence of soil-transmitted helminth infections), we reported means (including standard deviation [SD]) and proportions, respectively.\u003c/p\u003e\n\u003cp\u003eWe assessed the effect of the intervention on the occurrence of any soil-transmitted helminth, schistosome and pathogenic intestinal protozoa infections. Our analysis focused on the main effects of the interventions (i.e. CLTS vs non-CLTS and health education vs no health education). To account for the clustered study design, a random effect logistic regression models was used, taking into account the clustering of participants in communities. Effect measures are presented as odds ratios (ORs) and 95% confidence intervals (CIs). The main analysis included only the intervention as fixed effect. The threshold for statistical significance was set at p \u0026lt;0.05. To assess the impact of unsatisfactory intervention adherence, a subgroup analysis was done with communities reaching a minimal latrine coverage of 75% (complier) compared to matching control communities.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eParticipation in the study\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFigure 3\u0026nbsp;provides an overview of the number of participants who were recruited at baseline, those lost to follow-up and those retained for the final analysis. Study participants were recruited in August and September 2014 in 56 localities in three departments. For the baseline survey, 5,292 participants from 1,267 households were enrolled for the implementation of the study. At the end of this survey, two localities comprising 21 households and 62 participants were not taken into account in the randomisation because no soil-transmitted helminth infection was found. Randomisation took place in 54 localities with 1,246 households including 5,230 participants.\u0026nbsp;Allocations for the interventions were structured as follows: (i) preventive chemotherapy: 14 localities, 300 households, 1,344 participants; (ii) preventive chemotherapy plus CLTS: 13 localities, 312 households, 1,362 participants; (iii) preventive chemotherapy plus health education: 14 localities, 335 households, 1,305 participants; and (iv) all interventions: 13 localities, 299 households, 1,219 participants. Overall, 2084 (39.8%) participants were lost to follow-up at the first and 2740 (52.4%) at the second follow-up survey.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eBaseline characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe demographic and socioeconomic characteristics, WASH indicators, prevalence of soil-transmitted helminth, schistosome and pathogenic intestinal protozoa infections at baseline are summarised in Table 1. Across control and all intervention arms, more than 40% of households had between 6 and 10 individuals. The average number of inhabitants was similar in all arms (9-10 people). On average, 4 people were registered per household to participate in the study. In terms of household occupations, over 90% of households were primarily engaged in subsistence agriculture. Least poor households represented less than 25% of the households interviewed, regardless of the intervention arm. Except for the control arm where 18.6% of households were observed to have piped water (tap water), drinking water coverage rates were below 5% in the intervention arms. The proportions of latrines and their usage rates were: (i) control (20.1%, 16.4%); (ii) CLTS (14.9%, 14.2%); (iii) health education (27.2%, 26.2%); and (iv) CLTS plus health education (21.5%, 18.3%). Open defecation was widely reported (\u0026gt;75%) in control and all intervention arms. Less than 20% of the households in the four groups were not defecating in the open during this assessment.\u0026nbsp;Except for \u003cem\u003eS.\u0026nbsp;mansoni\u003c/em\u003e, participants in the four arms were similar in terms of parasitic infection prevalence. Hookworm was the predominant infection (19.9-22.9%), followed by \u003cem\u003eG. intestinalis\u0026nbsp;\u003c/em\u003e(12.6-13.4%).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEffect of interventions on health outcomes\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTable 2\u0026nbsp;provides the results for the primary and secondary outcomes. We observed at the first follow-up 17 months post intervention a prevalence in hookworm infections of 4.3% (69/1594) in the non-CLTS arms compared to 3.8% (59/1552) in the CLTS arms (supplementary table 1). This difference lacked statistical significance (OR 0.87, 95% CI 0.45 to 1.68, p = 0.69). During the second follow up at 38 months post-intervention, we observed a prevalence of 1.9% (24/1278) in the non-CLTS arms compared to 2.1% (26/1212) in the CLTS arms. This difference was not statistically significant (OR 1.15, 95% CI 0.60 to 2.17, p = 0.68). As regards secondary outcomes, we found no statistically significant differences.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAdherence to CLTS intervention\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFigure 4\u0026nbsp;shows latrine coverage in the study villages at baseline and follow-up survey 1, stratified by study arm.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eOf the 26 localities in arms 2 and 4, where CLTS had been implemented, 11 had achieved a latrine coverage rate of over 80%. Of these, there were 2 and 4 localities in arms 2 and 4, respectively that achieved 100% coverage. Six and 2 localities in arms 2 and 4, respectively, had coverage rates between 20% and 60%. Low coverage (\u0026lt;20%) was observed in 4 localities, namely one locality in arm 2 and 3 localities in arm 4. No change was recorded in one locality (i.e. Gbamel\u0026egrave;kro) of arm 2, as well as in 2 localities (i.e. Ahondo and N\u0026rsquo;Kloidjo) of arm 4, in terms of latrine coverage (identical latrine rates during both surveys).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEffect of interventions on primary and secondary outcomes in adhering communities\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo better elucidate the effect of interventions, we carried out a subgroup analysis using the 11 communities with the best adherence to the CLTS intervention. Those communities had a latrine coverage at follow-up of at least 75%. We matched those to 11 communities in the non-CLTS arms based on baseline latrine coverage and community size. In this analysis, we found no statistically significant difference in the primary outcome (Table 3). Surprisingly, at follow-up survey 2, we observed a higher prevalence of giardiasis in the CLTS intervention group compared to the control group (14.0% vs 2.5%; OR=6.47, 95% CI: 2.49-16.81; p\u0026lt;0.01) (Table 3).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003ePreventive chemotherapy, periodically administering anthelminthic drugs to at-risk populations, is the mainstay of morbidity control and might also reduce environmental contamination. However, there is broad understanding that this strategy alone fails to interrupt transmission. An integrated approach with preventive chemotherapy plus WASH interventions and health education has long been advocated as a means of enhancing the control and elimination of helminthiasis and intestinal protozoa infection[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. This study was undertaken to assess whether an integrated approach indeed can reduce reinfection patterns of helminths and intestinal protozoa. Our cluster randomised trial conducted in 54 communities in C\u0026ocirc;te d\u0026rsquo;Ivoire with a follow-up period of up to 38 months showed no significant impact on reinfection patterns.\u003c/p\u003e \u003cp\u003eThrough a local participatory approach, CLTS aims at increasing latrine coverage and use and put an end to open defecation and maintain this status within communities[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Along with health education that might reinforce CLTS, the two interventions might induce behaviour change. Initially developed as an approach to reduce the incidence of diarrhoea, these interventions also hold promise to prevent infections due to helminths and intestinal protozoa that share transmission routes as infective stages are excreted in human stool (or urine for \u003cem\u003eS. haematobium\u003c/em\u003e)[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]\u003csup\u003e,\u003c/sup\u003e[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. This study found no evidence that the CLTS intervention (alone or in combination with health education) significantly reduced the incidence of parasitic infections investigated in rural communities compared to standard preventive chemotherapy. Two prior RCTs evaluating a total sanitation programme in India, similarly reported no measurable effect on soil-transmitted helminth post-intervention infection status in the CLTS groups[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e], while a slight reduction of \u003cem\u003eG. intestinalis\u003c/em\u003e infections was noted in the follow-up in rural Madhya Pradesh[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. In Indonesia, only weak evidence for \u003cem\u003eA. lumbricoides\u003c/em\u003e intensity reduction was found in children from CLTS receiving communities compared to control communities[\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDifferent explanations might explain these observations. The time frame is one. Authors stipulate that to better measure the effect of such interventions on health benefits, long-term research projects should be implemented (i.e. years rather than months)[\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. They support their argument by the fact that faecal-oral pathogens cannot disappear in the environment in a short time. In our study, the time frame may have been too short taking into account the observed low transmission pressure of the primary outcome (i.e. soil-transmitted helminth infection) with low prevalence rates observed at both follow-ups in all intervention arms. Related to the potentially too short assessment intervals are the slow uptake of the intervention and low latrine coverage rates. While certain studies implied minimal coverage rates before starting to include measurements to the analysis,[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e] we chose to re-trigger communities with low latrine construction rates and included a second later assessment time point. Yet, we still had quite few communities receiving CLTS remaining under the expected latrine construction goals. A recent study carried out in Ghana (evaluation 10 years after implementation of CLTS) showed that long time frames are necessary to enhance sustainability. This led to a reduction in the number of people not defecating in the open; hence, improvement of sanitation and hygiene, as well as strengthening the application of community rules and regulations regarding WASH[\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAnother factor is the limited potential of CLTS to \u0026ldquo;clean\u0026rdquo; the environment from faecal pathogens. Instead of reducing the risk of infection, unimproved latrine types and construction materials as well as inappropriate use may create new infection sources[\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. In the CLTS approach subsidies for materials to construct latrines are not foreseen and each community came up with its own model of a basic latrine that was affordable and feasible for it to be built.\u003c/p\u003e \u003cp\u003eLastly also the human behaviour factor remains difficult to be controlled for the perceptibility of actions. Behaviour change needs time and besides inappropriate or inconsistent use of latrines, community members may further continue other risky behaviours that foster faecal-oral transmission of pathogens (e.g. contaminated hands from anal cleansing, no handwashing and food contamination during production, preparation or consumption).\u003c/p\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003eStrengths and limitations\u003c/h2\u003e \u003cp\u003eThe design, methods and approach of the study were robust. RCTs offer the greatest potential for causal inference. In order to ensure homogeneous stratification, villages were randomly allocated to different groups (control, intervention) after the baseline survey. This led to similar baseline characteristics and outcome variables (i.e. parasitic infections) across the four arms. Intensified monitoring and evaluation coupled with remobilisation were undertaken to enhance compliance to the CLTS intervention. Our study provides evidence from two follow-up assessments, the later exceeding the time frame of most comparable trials assessing the effect of CLTS intervention on parasitic infections[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Although embedded in an RCT, the data generated are close to real-life data, as both the preventive chemotherapy was conducted by the usual actors under their conditions and the CLTS intervention was led by national teams as implemented elsewhere in the country.\u003c/p\u003e \u003cp\u003eThe limitations of this study come with the complexity of the conduct of a series of different interventions that are executed by a variety of actors and need alignment. Not all interventions always happened in anticipated timeframes and although mitigation strategies and intensified monitoring were put in place, not all receiving communities took up the interventions as planned. Particularly large communities experienced difficulty in adhering to the implementation of the CLTS intervention, and consequently in achieving \u0026ldquo;open defecation free (ODF)\u0026rdquo; status. A monitoring system over time could not be put in place after the certification of villages for \u0026ldquo;ODF\u0026rdquo; status (post-intervention). In view of this unique and stagnant evaluation of the contamination status with faecal matter and associated pathogens, as well as the lack of environmental analyses, it is not possible to make a definitive appraisal of the true situation. No direct observations of human behaviour were part of this study. Hence, we cannot rule out that community members continued to engage in risky behaviours (e.g. open defecation, not washing hands, unclean food preparation or storage). Another limiting aspect concerns the main study outcome that is infection with any soil-transmitted helminth. Infection rates at the start of the study were relatively low and transmission dynamics appear to be slower than expected in the study area, as reflected by the low reinfection rates in all study arms (including the control arm). These low figures contradicted the hypothesis that communities had returned to their initial prevalence rates at that point in time (i.e. hookworm prevalence\u0026thinsp;\u0026gt;\u0026thinsp;20%). Our trial was not powered to detect small but from a public health point of view important effects as significant differences. Reassessments in low-to-moderate transmission sites may require longer intervals in-between full intervention uptake and outcome assessment. Additionally, loss to follow-up (40\u0026ndash;50%) was higher than anticipated and might have impacted the evaluation of the interventions.\u003c/p\u003e \u003cp\u003eTo be able to measure an impact on parasitic diseases from integrated interventions, including WASH compared to standard preventive chemotherapy in settings with lower transmission burden, a study with a much longer time frame may be considered. A more rigid evaluation approach to explore environmental contamination status of the communities (also including built latrines and consumed water and food) is recommended to accompany similar future trials.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusions","content":"\u003cp\u003eAlthough there were reductions in the prevalence of soil-transmitted helminth infection, in particular hookworm, no statistically significant synergistic effect of the integrative intervention packages compared to standard preventive chemotherapy could be observed during both follow-up surveys. We advocate comprehensive studies that can quantitatively and qualitatively assess the impact of CLTS interventions at the community level over a longer period. As efforts are made to improve coverage of CLTS interventions within rural communities, we emphasise that implementation must be rigorously designed and implemented to achieve the goals of reducing exposure to pathogens and improvement of people\u0026rsquo;s health and wellbeing.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003e\u003cstrong\u003eCHW\u003c/strong\u003e Community Health Worker\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCI\u003c/strong\u003e Confidence Interval\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCLTS\u003c/strong\u003e Community-Led total Sanitation\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFGD\u003c/strong\u003e Focus Group Discussion\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eHDSS \u003c/strong\u003e Health Demographic Surveillance System\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eISRCTN \u003c/strong\u003e International Standard Randomised Controlled Trial Number\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eKAPB\u003c/strong\u003e Knowledge, Attitudes, Practice and Behaviour\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eODF \u003c/strong\u003eOpen Defecation Free\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eODK\u003c/strong\u003e Open Data Kit\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOR\u003c/strong\u003e Odds Ratio\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRCT \u003c/strong\u003e Randomised Controlled Trial\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSAF\u003c/strong\u003e Sodium acetate-Acetic acid-Formalin\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSD \u003c/strong\u003eStandard Deviation\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSTH \u003c/strong\u003e Soil-Transmitted Helminth\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eUNICEF \u003c/strong\u003eUnited Nations Children\u0026apos;s Fund\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eWASH \u003c/strong\u003e Water Sanitation and Hygiene\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eWHO\u003c/strong\u003e World Health Organisation\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics Approval and Consent to Participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eApproval of the study protocol was granted by the institutional research commission of the Centre Suisse de Recherches Scientifiques en C\u0026ocirc;te d\u0026rsquo;Ivoire (CSRS; Abidjan, C\u0026ocirc;te d\u0026rsquo;Ivoire). Ethical clearance for the study was obtained from the Ethics Committee of Basel (EKBB; reference no. 300/13, date of approval: 11 November 2013) and from the ethics committee of the Ministry of Health and Public Hygiene in C\u0026ocirc;te d\u0026rsquo;Ivoire (reference no. 76-MSLS-CNER-dkn, date of approval: 28 November 2013). The trial is registered (ISRCTN53102033, date of approval: 26 March 2014 https://www.isrctn.com/ISRCTN53102033).\u003c/p\u003e\n\u003cp\u003eThe purpose and procedures of the study were explained to local authorities (village chiefs) and community members. Written informed consent was obtained from all participants (parents/legal guardians signed for children below the age of 18 years). For illiterate participants, impartial witnessers provided signature. Participation was voluntary and withdrawal from the study was possible anytime without further obligations. Moreover, it was mentioned that preventive chemotherapy was provided to all people in the study area, not just those who decide to participate, free of charge through the National Programme for the Control of Neglected Tropical Diseases.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData collected for the study, anonymised participant data, and a data dictionary defining each field in the set, will be made available to others on reasonable request. De-identified participant data of the requested dataset plus a data dictionary will be made available on reasonable request immediately following publication for at least 1 year. Access will be granted to researchers who provide a methodologically sound proposal. Principal investigators, and collaborators will approve the proposals on the basis of scientific merit. Requests should be directed to the corresponding author. Researchers requesting data will need to sign a data access agreement before they are granted access. Study protocol is available on study registry page (ISRCTN53102033).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFunding was provided by UBS Optimus Foundation (Zurich, Switzerland) and the R. Geigy Foundation (Basel, Switzerland). The funders of this study had no role in study design, data collection, data analysis, data interpretation or writing of the paper.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eGaoussou Coulibaly (data collection, data management, data analysis and interpretation and writing of first draft); Eveline H\u0026uuml;rlimann (data management, data collection, coordination, supervision, critical input to manuscript development); Mamadou Ouattara (coordination, data collection, supervision, quality assurance); Kouassi Dongo (coordination, supervision); Jan Hattendorf (randomisation, data analysis and interpretation, critical input to manuscript development); Fabien Zouzou (intervention conduct and monitoring, coordination, supervision); Fid\u0026egrave;le K. Bassa, Richard B. Yapi and Naf\u0026eacute;rima Kon\u0026eacute; (data collection); V\u0026eacute;ronique A. Koffi\u003csup\u003e\u0026nbsp;\u003c/sup\u003e(data collection and data management, conduct of intervention); Cl\u0026eacute;mence Esse (conceptualization and conduct of intervention, data collection, coordination, supervision); J\u0026uuml;rg Utzinger (project conceptualization, coordination, supervision, critical review to manuscript); Giovanna Raso (project conceptualization, coordination, supervision, fund raising, reporting, project management); Eli\u0026eacute;zer K. N\u0026rsquo;Goran (project conceptualization, supervision, coordination). All authors read and approved the final version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe thank the Ministry of Sanitation and Drainage of C\u0026ocirc;te d\u0026rsquo;Ivoire and the United Nations Children\u0026rsquo;s Fund (UNICEF) office in C\u0026ocirc;te d\u0026rsquo;Ivoire for their authorisation and support. We extend our gratitude for the collaboration and support we received from PNLMTN-CP for the treatment of the communities. \u0026nbsp;We are very grateful to the Community Health Workers (CHW) and CLTS facilitators for their effective contribution in the field. A special mention to the rural communities for their enthusiastic participation. We would like to thank Cyrille K. Konan, Agodio Loukouri, Nab\u0026eacute;l\u0026eacute;kounon Tuo, N\u0026rsquo;Tamon N. Rom\u0026eacute;o, Ambroise Apala, Honorine Moro, St\u0026eacute;phane Y. Babo and the Taabo HDSS team for their invaluable commitment to collect data. The authors express their gratitude to the laboratory technicians, namely: Laurent K. Lohourignon (Rest In Peace, 13 march 2025), Arthur Anzara, Mamadou Traor\u0026eacute; (Mister Tee), Salia Diabat\u0026eacute;, S\u0026eacute;raphin Kouadio, Rapha\u0026euml;l G. Diabr\u0026eacute; (Paco), Valian Kouadio, Gauthier Meledge their contribution to the quality of the data collected.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eWong LW, Ong KS, Khoo JR, Goh CBS, Hor JW, Lee SM. Human intestinal parasitic infection: a narrative review on global prevalence and epidemiological insights on preventive, therapeutic and diagnostic strategies for future perspectives. Expert Rev Gastroenterol Hepatol. 2020;14: 1093\u0026ndash;1105. doi:10.1080/17474124.2020.1806711\u003c/li\u003e\n\u003cli\u003eWolf J, Johnston RB, Ambelu A, Arnold BF, Bain R, Brauer M, et al. Burden of disease attributable to unsafe drinking water, sanitation, and hygiene in domestic settings: a global analysis for selected adverse health outcomes. Lancet. 2023;401: 2060\u0026ndash;2071. doi:10.1016/S0140-6736(23)00458-0\u003c/li\u003e\n\u003cli\u003eGBD 2015 DALYs and HALE Collaborators. 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Available: https://apps.who.int/iris/handle/10665/43545\u003c/li\u003e\n\u003cli\u003eJia T-W, Melville S, Utzinger J, King CH, Zhou X-N. Soil-transmitted helminth reinfection after drug treatment: a systematic review and meta-analysis. PLoS Negl Trop Dis. 2012;6: e1621. doi:10.1371/journal.pntd.0001621\u003c/li\u003e\n\u003cli\u003eKar K, Chambers R. Handbook on community-led total sanitation. London: Plan UK; 2008. \u003c/li\u003e\n\u003cli\u003eH\u0026uuml;rlimann E, Silu\u0026eacute; KD, Zouzou F, Ouattara M, Schmidlin T, Yapi RB, et al. Effect of an integrated intervention package of preventive chemotherapy, community-led total sanitation and health education on the prevalence of helminth and intestinal protozoa infections in C\u0026ocirc;te d\u0026rsquo;Ivoire. Parasit Vectors. 2018;11: 115. doi:10.1186/s13071-018-2642-x\u003c/li\u003e\n\u003cli\u003eRaso G, Ess\u0026eacute; C, Dongo K, Ouattara M, Zouzou F, H\u0026uuml;rlimann E, et al. 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Effects of hygiene and defecation behavior on helminths and intestinal protozoa infections in Taabo, C\u0026ocirc;te d\u0026rsquo;Ivoire. PLoS ONE. 2013;8: e65722. doi:10.1371/journal.pone.0065722\u003c/li\u003e\n\u003cli\u003eBecker SL, Sieto B, Silu\u0026eacute; KD, Adjossan L, Kon\u0026eacute; S, Hatz C, et al. Diagnosis, clinical features, and self-reported morbidity of Strongyloides stercoralis and hookworm infection in a Co-endemic setting. PLoS Negl Trop Dis. 2011;5: e1292. doi:10.1371/journal.pntd.0001292\u003c/li\u003e\n\u003cli\u003eLemeshow S, Tserkovnyi AG, Tulloch JL, Dowd JE, Lwanga SK, Keja J. A computer simulation of the EPI survey strategy. Int J Epidemiol. 1985;14: 473\u0026ndash;481. doi:10.1093/ije/14.3.473\u003c/li\u003e\n\u003cli\u003eCoulibaly G, Ouattara M, Dongo K, H\u0026uuml;rlimann E, Bassa FK, Kon\u0026eacute; N, et al. Epidemiology of intestinal parasite infections in three departments of south-central C\u0026ocirc;te d\u0026rsquo;Ivoire before the implementation of a cluster-randomised trial. Parasite Epidemiol Control. 2018;3: 63\u0026ndash;76. doi:10.1016/j.parepi.2018.02.003\u003c/li\u003e\n\u003cli\u003eMoulton LH. Covariate-based constrained randomization of group-randomized trials. Clin Trials. 2004;1: 297\u0026ndash;305. doi:10.1191/1740774504cn024oa\u003c/li\u003e\n\u003cli\u003eEss\u0026eacute; C, Koffi VA, Kouam\u0026eacute; A, Dongo K, Yapi RB, Moro HM, et al. \u0026ldquo;Koko et les lunettes magiques\u0026rdquo;: An educational entertainment tool to prevent parasitic worms and diarrheal diseases in C\u0026ocirc;te d\u0026rsquo;Ivoire. PLoS Negl Trop Dis. 2017;11: e0005839. doi:10.1371/journal.pntd.0005839\u003c/li\u003e\n\u003cli\u003eKatz N, Chaves A, Pellegrino J. A simple device for quantitative stool thick-smear technique in Schistosomiasis mansoni. Rev Inst Med Trop Sao Paulo. 1972;14: 397\u0026ndash;400. \u003c/li\u003e\n\u003cli\u003ePlouvier S, Leroy J-C, Colette J. A propos d\u0026rsquo;une technique simple de filtration des urines dans le diagnostic de la bilharziose urinaire en enqu\u0026ecirc;te de masse. Med Trop. 1975; 229\u0026ndash;230. \u003c/li\u003e\n\u003cli\u003eUtzinger J, Botero-Kleiven S, Castelli F, Chiodini PL, Edwards H, K\u0026ouml;hler N, et al. Microscopic diagnosis of sodium acetate-acetic acid-formalin-fixed stool samples for helminths and intestinal protozoa: a comparison among European reference laboratories. Clinical Microbiology and Infection. 2010;16: 267\u0026ndash;273. doi:10.1111/j.1469-0691.2009.02782.x\u003c/li\u003e\n\u003cli\u003eWorld Health Organization. Global report on neglected tropical diseases 2023. Geneva: World Health Organization, 2023. [cited 5 Sep 2025]. Available: https://www.who.int/teams/control-of-neglected-tropical-diseases/global-report-on-neglected-tropical-diseases-2023\u003c/li\u003e\n\u003cli\u003ePatil SR, Arnold BF, Salvatore AL, Briceno B, Ganguly S, Colford JM, et al. The effect of India\u0026rsquo;s total sanitation campaign on defecation behaviors and child health in rural Madhya Pradesh: a cluster randomized controlled trial. PLoS Med. 2014;11: e1001709. doi:10.1371/journal.pmed.1001709\u003c/li\u003e\n\u003cli\u003eCrocker J, Fuente D, Bartram J. Cost effectiveness of community led total sanitation in Ethiopia and Ghana. Int J Hyg Environ Health. 2021;232: 113682. doi:10.1016/j.ijheh.2020.113682\u003c/li\u003e\n\u003cli\u003ePickering AJ, Djebbari H, Lopez C, Coulibaly M, Alzua ML. Effect of a community-led sanitation intervention on child diarrhoea and child growth in rural Mali: a cluster-randomised controlled trial. Lancet Glob Health. 2015;3: e701-711. doi:10.1016/S2214-109X(15)00144-8\u003c/li\u003e\n\u003cli\u003eBartram J, Cairncross S. Hygiene, Sanitation, and Water: Forgotten Foundations of Health. PLOS Medicine. 2010;7: e1000367. doi:10.1371/journal.pmed.1000367\u003c/li\u003e\n\u003cli\u003eClasen T, Boisson S, Routray P, Torondel B, Bell M, Cumming O, et al. Effectiveness of a rural sanitation programme on diarrhoea, soil-transmitted helminth infection, and child malnutrition in Odisha, India: a cluster-randomised trial. Lancet Glob Health. 2014;2: e645-653. doi:10.1016/S2214-109X(14)70307-9\u003c/li\u003e\n\u003cli\u003eCameron L, Olivia S, Shah M. Scaling up sanitation: Evidence from an RCT in Indonesia. J Dev Econ. 2019;138: 1\u0026ndash;16. doi:10.1016/j.jdeveco.2018.12.001\u003c/li\u003e\n\u003cli\u003eSchmidt W-P. Seven trials, seven question marks. The Lancet Global Health. 2015;3: e659\u0026ndash;e660. doi:10.1016/S2214-109X(15)00182-5\u003c/li\u003e\n\u003cli\u003eChirgwin H, Cairncross S, Zehra D, Sharma Waddington H. Interventions promoting uptake of water, sanitation and hygiene (WASH) technologies in low- and middle-income countries: An evidence and gap map of effectiveness studies. Campbell Syst Rev. 2021;17: e1194. doi:10.1002/cl2.1194\u003c/li\u003e\n\u003cli\u003eAdam E, Badu E. Community-led total sanitation (CLTS) implementation in West Mamprusi Municipal Assembly in Ghana. What do communities think eleven years on? Global Health Journal. 2024;8: 67\u0026ndash;73. doi:10.1016/j.glohj.2024.05.003\u003c/li\u003e\n\u003cli\u003eCha S, Jung S, Abera T, Beyene ET, Schmidt W-P, Ross I, et al. Performance of Pit Latrines and Their Herd Protection Against Diarrhea: A Longitudinal Cohort Study in Rural Ethiopia. Glob Health Sci Pract. 2024;12: e2200541. doi:10.9745/GHSP-D-22-00541\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cdiv align=\"\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"777\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"16\" valign=\"bottom\" style=\"width: 777px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable1.\u003c/strong\u003e Baseline characteristics of included households in terms of population, occupation, Water, Sanitation and Hygiene (WASH) indicators and parasitic infection prevalence by randomized intervention group \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 188px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 188px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eControl\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInterventions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCLTS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCHEP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCLTS+CHEP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 188px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eN\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean (SD) or Percent\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eN\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean (SD) or Percent\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eN\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean (SD) or Percent\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eN\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean (SD) or Percent\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 188px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"3\" valign=\"bottom\" style=\"width: 213px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHousehold characteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"3\" valign=\"bottom\" style=\"width: 213px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of enrolled households\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e300\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e312\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e335\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e299\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"4\" valign=\"bottom\" style=\"width: 226px;\"\u003e\n \u003cp\u003eNumber of enrolled children per household\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 201px;\"\u003e\n \u003cp\u003eAge \u0026lt;5 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e0.5 (0.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.3 (0.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.3 (0.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.4 (0.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 201px;\"\u003e\n \u003cp\u003eAge 5-15 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e3.1 (1.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e3.2 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e2.8 (1.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e3.0 (2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 201px;\"\u003e\n \u003cp\u003eNumber of enrolled adolescents and adults per households\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e0.8 (0.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.8 (0.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.8 (0.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.7 (0.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"4\" valign=\"bottom\" style=\"width: 226px;\"\u003e\n \u003cp\u003eNumber of participants per households\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e4.5 (2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e4.4 (2.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e3.9 (1.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e4.1 (2.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"3\" valign=\"bottom\" style=\"width: 213px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDemography\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 201px;\"\u003e\n \u003cp\u003eN. household questionnaire\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e274\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e288\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e294\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e251\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 188px;\"\u003e\n \u003cp\u003e\u0026le;5 people\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e16.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e21.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e20.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e20.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 201px;\"\u003e\n \u003cp\u003e6-10 people\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e46.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e125\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e43.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e49.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e46.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u0026gt;10 people\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e38.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e101\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e35.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e29.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e33.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 201px;\"\u003e\n \u003cp\u003eNumber of people per household\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 25px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e9.9 (5.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e10.0 (6.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e9.4 (5.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e10.3 (6.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"4\" valign=\"bottom\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eActivities\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 188px;\"\u003e\n \u003cp\u003eAgriculture\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e247\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e90.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e266\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e92.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e266\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e90.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e233\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e92.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 188px;\"\u003e\n \u003cp\u003eFishing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e2.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e3.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e5.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e2.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 188px;\"\u003e\n \u003cp\u003eOther occupations*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e7.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e4.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e4.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e5.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 188px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWealth quartiles\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 188px;\"\u003e\n \u003cp\u003eMost poor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e23.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e30.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e29.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e37.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 188px;\"\u003e\n \u003cp\u003eVery poor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e24.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e26.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e22.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e21.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 188px;\"\u003e\n \u003cp\u003ePoor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e28.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e19.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e25.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e18.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 188px;\"\u003e\n \u003cp\u003eLeast poor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e23.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e24.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e23.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e22.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"6\" valign=\"bottom\" style=\"width: 339px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWater, Sanitation and Hygiene (WASH) indicators\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"3\" valign=\"bottom\" style=\"width: 213px;\"\u003e\n \u003cp\u003eHouseholds with tap water\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 87px;\"\u003e\n \u003cp\u003e18.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e0.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003e4.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"4\" valign=\"bottom\" style=\"width: 226px;\"\u003e\n \u003cp\u003eOther sources of water for households**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e223\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e81.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e287\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e99.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e294\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e100%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e239\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e95.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"3\" valign=\"bottom\" style=\"width: 213px;\"\u003e\n \u003cp\u003eHouseholds with latrines\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 87px;\"\u003e\n \u003cp\u003e20.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e14.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e27.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003e21.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"3\" valign=\"bottom\" style=\"width: 213px;\"\u003e\n \u003cp\u003eUse of latrines by households\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 188px;\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e216\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 87px;\"\u003e\n \u003cp\u003e78.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e243\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e84.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e207\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e70.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e202\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003e80.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 188px;\"\u003e\n \u003cp\u003eRarely\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 87px;\"\u003e\n \u003cp\u003e2.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e1.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003e0.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 188px;\"\u003e\n \u003cp\u003eOften\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 87px;\"\u003e\n \u003cp\u003e2.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e1.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e1.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003e0.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 188px;\"\u003e\n \u003cp\u003eAlways\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 87px;\"\u003e\n \u003cp\u003e16.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e14.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e26.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003e18.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"4\" valign=\"bottom\" style=\"width: 226px;\"\u003e\n \u003cp\u003ePractice of open defecation by households\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e227\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 87px;\"\u003e\n \u003cp\u003e82.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e220\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e76.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e233\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e79.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e192\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003e76.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"3\" valign=\"bottom\" style=\"width: 213px;\"\u003e\n \u003cp\u003eDefecation in plantation/field\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 188px;\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 87px;\"\u003e\n \u003cp\u003e13.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e11.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e16.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003e8.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 188px;\"\u003e\n \u003cp\u003eRarely\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 87px;\"\u003e\n \u003cp\u003e10.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e13.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e13.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003e11.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 188px;\"\u003e\n \u003cp\u003eOften\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e114\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 87px;\"\u003e\n \u003cp\u003e41.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e146\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e50.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e149\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e50.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e112\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003e44.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 188px;\"\u003e\n \u003cp\u003eAlways\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 87px;\"\u003e\n \u003cp\u003e34.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e19.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e19.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003e35.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"3\" valign=\"bottom\" style=\"width: 213px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIndividual characteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"4\" valign=\"bottom\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDemography N\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1344\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1362\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1305\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1219\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"4\" valign=\"bottom\" style=\"width: 226px;\"\u003e\n \u003cp\u003eSex (Number of individuals /Number\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eof participants\u003cstrong\u003e)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"4\" valign=\"bottom\" style=\"width: 226px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e686\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e51.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e676\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e49.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e645\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e49.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e610\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e50.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"4\" valign=\"bottom\" style=\"width: 226px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e658\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e49.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e686\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e50.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e660\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e50.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e609\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e50.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"4\" valign=\"bottom\" style=\"width: 226px;\"\u003e\n \u003cp\u003eAge (Number of individuals/Number\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eof participants\u003cstrong\u003e)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"4\" valign=\"bottom\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u0026lt; 5 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e150\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e11.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e7.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e7.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e105\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e8.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"4\" valign=\"bottom\" style=\"width: 226px;\"\u003e\n \u003cp\u003e5-15 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e940\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e69.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e1002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e73.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e948\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e72.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e904\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e74.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"4\" valign=\"bottom\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u0026gt;15 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e254\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e18.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 29px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e256\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e18.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e264\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e20.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 14px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e210\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e17,2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"3\" valign=\"bottom\" style=\"width: 213px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eParasitic infections\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"3\" valign=\"bottom\" style=\"width: 213px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber individuals with KK result\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1289\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1290\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1212\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1194\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 188px;\"\u003e\n \u003cp\u003eHookworm\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e281\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 87px;\"\u003e\n \u003cp\u003e21.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e273\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e21.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e277\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e22.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e238\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003e19.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 188px;\"\u003e\n \u003cp\u003e\u003cem\u003eTrichuris trichiura\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 87px;\"\u003e\n \u003cp\u003e2.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e1.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e2.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e22\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003e1.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 188px;\"\u003e\n \u003cp\u003e\u003cem\u003eAscaris lumbricoides\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 87px;\"\u003e\n \u003cp\u003e0.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e0.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003e0.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 188px;\"\u003e\n \u003cp\u003e\u003cem\u003eSchistosoma mansoni\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 87px;\"\u003e\n \u003cp\u003e0.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e1.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e7.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003e3.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"4\" valign=\"bottom\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber individuals with UF result\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1336\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1348\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1294\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1203\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 188px;\"\u003e\n \u003cp\u003e\u003cem\u003eSchistosoma haematobium\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 87px;\"\u003e\n \u003cp\u003e3.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e4.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e3.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003e2.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"4\" valign=\"bottom\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber individuals with ECM result\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1228\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1227\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1149\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1120\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 188px;\"\u003e\n \u003cp\u003e\u003cem\u003eGiardia lamblia\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e157\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 87px;\"\u003e\n \u003cp\u003e12.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e164\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e13.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e12.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e141\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003e12.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 188px;\"\u003e\n \u003cp\u003e\u003cem\u003eEntamoeba histolytica/dispar\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 87px;\"\u003e\n \u003cp\u003e6.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 49px;\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e5.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e6.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003e5.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eAbbreviations: PC, Preventive chemotherapy; CLTS, Community-led total sanitation; CHEP, Community health education program; SD, Standard deviation, KK, Kato-katz; UF, Urine filtration, ECM, Ether-concentration method\u003c/p\u003e\n\u003cp\u003e* Other occupations include: housewife, trader, teacher, animal breeder \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e** Other sources of water include : Drilling/pump, well, river/backwater/pond\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2.\u0026nbsp;\u003c/strong\u003eEffect of the intervention on primary and secondary outcomes\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"879\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 213px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\" style=\"width: 167px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCLTS Yes vs No \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; OR (95% CI) \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 213px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eControl\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCLTS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCHEP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCLTS+CHEP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 213px;\"\u003e\n \u003cp\u003en FU1 (by diagnostic approach)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e879*|922\u0026quot;|868^\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e882*|916\u0026quot;|873^\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e715*|783|707^\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e670*|696\u0026quot;|662^\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 213px;\"\u003e\n \u003cp\u003en FU2 (by diagnostic approach)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e689*|757\u0026quot;|689^\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e659*|721\u0026quot;|653^\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e589*|662\u0026quot;|587^\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e553*|606\u0026quot;|552^\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"8\" valign=\"bottom\" style=\"width: 879px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrimary outcome (STH infection status)*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 213px;\"\u003e\n \u003cp\u003eHookworm FU1\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e39 (4.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e29 (3.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e30 (4.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e30 (4.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" style=\"width: 167px;\"\u003e\n \u003cp\u003e0.87 (0.45-1.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 58px;\"\u003e\n \u003cp\u003e0.69\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 213px;\"\u003e\n \u003cp\u003eHookworm FU2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e15 (2.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e10 (1.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e9 (1.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e16 (2.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" style=\"width: 167px;\"\u003e\n \u003cp\u003e1.14 (0.60-2.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 58px;\"\u003e\n \u003cp\u003e0.68\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 213px;\"\u003e\n \u003cp\u003e\u003cem\u003eTrichuris trichiura\u003c/em\u003e FU1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e7 (0.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e6 (0.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e9 (1.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e5 (0.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 109px;\"\u003e\n \u003cp\u003eND\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 57px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 58px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 213px;\"\u003e\n \u003cp\u003e\u003cem\u003eTrichuris trichiura\u003c/em\u003e FU2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e3 (0.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e3 (0.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 109px;\"\u003e\n \u003cp\u003eND\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 57px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 58px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 213px;\"\u003e\n \u003cp\u003e\u003cem\u003eAscaris lumbricoides\u003c/em\u003e FU1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e1 (0.1))\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e1 (0.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e3 (0.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 109px;\"\u003e\n \u003cp\u003eND\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 57px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 58px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 213px;\"\u003e\n \u003cp\u003e\u003cem\u003eAscaris lumbricoides\u003c/em\u003e FU2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 109px;\"\u003e\n \u003cp\u003eND\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 57px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 58px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"8\" valign=\"bottom\" style=\"width: 879px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSecondary outcome (\u003cem\u003eSchistosoma spp\u003c/em\u003e. \u0026amp; intestinal protozoa infection status)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"8\" valign=\"bottom\" style=\"width: 879px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eSchistosoma spp\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e\u003cem\u003eSchistosoma mansoni\u0026nbsp;\u003c/em\u003eFU1*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e2 (0.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e5 (0.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e23 (3.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e23 (3.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 167px;\"\u003e\n \u003cp\u003e1.15 (0.20-6.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e0.87\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e\u003cem\u003eSchistosoma mansoni\u003c/em\u003e FU2*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e6 (0.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e32 (5.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e15 (2.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 167px;\"\u003e\n \u003cp\u003e0.69 (0.08-5.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e\u003cem\u003eSchistosoma haematobium\u0026nbsp;\u003c/em\u003eFU1\u0026quot;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e13 (1.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e16 (1.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e14 (2,0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e26 (3.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 167px;\"\u003e\n \u003cp\u003e1.66 (0.48-5.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e0.42\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e\u003cem\u003eSchistosoma haematobium\u0026nbsp;\u003c/em\u003eFU2\u0026quot;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e32 (4.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e16 (2.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e19 (2.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e7 (1.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 167px;\"\u003e\n \u003cp\u003e0.47 (0.10-2.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e0.35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 213px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIntestinal protozoa^\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 109px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 57px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e\u003cem\u003eGiardia lamblia\u0026nbsp;\u003c/em\u003eFU1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e41 (4.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e51 (5.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e22 (3.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e30 (4.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 167px;\"\u003e\n \u003cp\u003e1.34 (0.84-2.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e\u003cem\u003eGiardia lamblia\u0026nbsp;\u003c/em\u003eFU2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e67 (9.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e79 (12.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e54 (9.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e64 (11.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 167px;\"\u003e\n \u003cp\u003e1.29 (0.96-1.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e\u003cem\u003eEntamoeba histolytica\u0026nbsp;\u003c/em\u003eFU1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e23 (2.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e22 (2.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e18 (2.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e16 (2.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 167px;\"\u003e\n \u003cp\u003e0.95 (0.51-1.76)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e0.87\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 213px;\"\u003e\n \u003cp\u003e\u003cem\u003eEntamoeba histolytica\u0026nbsp;\u003c/em\u003eFU2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e49 (7.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e34 (5.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e40 (6.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 110px;\"\u003e\n \u003cp\u003e41 (7.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 167px;\"\u003e\n \u003cp\u003e0.89 (0.67-1.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e0.39\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003ePC, Preventive chemotherapy; CLTS, Community-led total sanitation; CHEP, Community health education program; FU, Follow-up; STH, Soil-transmitted helminth; ND, Not determined\u003c/p\u003e\n\u003cp\u003eDiagnostic approaches: * Kato-katz; \u0026nbsp;\u0026quot;Urine filtration; ^Ether-concentration method\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3.\u0026nbsp;\u003c/strong\u003eEffect of the intervention on primary and secondary outcomes using complier matching for 11 localities in each CLTS (latrine coverage\u0026gt;75%) and no-CLTS\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"662\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 211px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\" style=\"width: 164px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCLTS Yes vs No \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; OR (95% CI) \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 62px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 211px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eno-CLTS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCLTS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 62px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 211px;\"\u003e\n \u003cp\u003en FU1 (by diagnostic approach)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 111px;\"\u003e\n \u003cp\u003e305*|332\u0026quot;|304^\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003e361*|372\u0026quot;|356^\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 62px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 211px;\"\u003e\n \u003cp\u003en FU2 (by diagnostic approach)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 111px;\"\u003e\n \u003cp\u003e239*|273\u0026quot;|238^\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003e293*|318\u0026quot;|293^\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 62px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"6\" valign=\"bottom\" style=\"width: 662px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrimary outcome (STH infection status)*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 211px;\"\u003e\n \u003cp\u003eHookworm FU1\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 111px;\"\u003e\n \u003cp\u003e11 (3.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003e26 (7.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" style=\"width: 164px;\"\u003e\n \u003cp\u003e2.07 (0.72-5.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 62px;\"\u003e\n \u003cp\u003e0.18\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 211px;\"\u003e\n \u003cp\u003eHookworm FU2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 111px;\"\u003e\n \u003cp\u003e4 (1.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003e13 (4.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" style=\"width: 164px;\"\u003e\n \u003cp\u003e2.72 (0.76-9.76)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 62px;\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 211px;\"\u003e\n \u003cp\u003e\u003cem\u003eTrichuris trichiura\u003c/em\u003e FU1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 111px;\"\u003e\n \u003cp\u003e5 (1.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003e5 (1.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 113px;\"\u003e\n \u003cp\u003eND\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 51px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 62px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 211px;\"\u003e\n \u003cp\u003e\u003cem\u003eTrichuris trichiura\u003c/em\u003e FU2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003e2 (0.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 113px;\"\u003e\n \u003cp\u003eND\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 51px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 62px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 211px;\"\u003e\n \u003cp\u003e\u003cem\u003eAscaris lumbricoides\u003c/em\u003e FU1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 111px;\"\u003e\n \u003cp\u003e2 (0.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 113px;\"\u003e\n \u003cp\u003eND\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 51px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 62px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 211px;\"\u003e\n \u003cp\u003e\u003cem\u003eAscaris lumbricoides\u003c/em\u003e FU2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 113px;\"\u003e\n \u003cp\u003eND\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 51px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 62px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"6\" valign=\"bottom\" style=\"width: 662px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSecondary outcome (\u003cem\u003eSchistosoma spp\u003c/em\u003e. \u0026amp; intestinal protozoa infection status)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" colspan=\"6\" valign=\"bottom\" style=\"width: 662px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eSchistosoma spp.\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 211px;\"\u003e\n \u003cp\u003e\u003cem\u003eSchistosoma mansoni\u0026nbsp;\u003c/em\u003eFU1*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 111px;\"\u003e\n \u003cp\u003e1 (0.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003e1 (0.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 113px;\"\u003e\n \u003cp\u003eND\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 51px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 62px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 211px;\"\u003e\n \u003cp\u003e\u003cem\u003eSchistosoma mansoni\u003c/em\u003e FU2*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003e1 (0.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 113px;\"\u003e\n \u003cp\u003eND\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 51px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 62px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 211px;\"\u003e\n \u003cp\u003e\u003cem\u003eSchistosoma haematobium\u0026nbsp;\u003c/em\u003eFU1\u0026quot;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 111px;\"\u003e\n \u003cp\u003e9 (2.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003e2 (0.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 113px;\"\u003e\n \u003cp\u003eND\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 51px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 62px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 211px;\"\u003e\n \u003cp\u003e\u003cem\u003eSchistosoma haematobium\u0026nbsp;\u003c/em\u003eFU2\u0026quot;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 111px;\"\u003e\n \u003cp\u003e11 (4.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003e2 (0.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 113px;\"\u003e\n \u003cp\u003eND\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 51px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 62px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 211px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIntestinal protozoa^\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 111px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 115px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 113px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 51px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 62px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 211px;\"\u003e\n \u003cp\u003e\u003cem\u003eGiardia lamblia\u0026nbsp;\u003c/em\u003eFU1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 111px;\"\u003e\n \u003cp\u003e14 (4.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003e16 (4.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 164px;\"\u003e\n \u003cp\u003e0.97 (0.42-2.26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 62px;\"\u003e\n \u003cp\u003e0.95\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 211px;\"\u003e\n \u003cp\u003e\u003cem\u003eGiardia lamblia\u0026nbsp;\u003c/em\u003eFU2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 111px;\"\u003e\n \u003cp\u003e6 (2.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003e41 (14.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 164px;\"\u003e\n \u003cp\u003e6.47 (2.49-16.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 62px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 211px;\"\u003e\n \u003cp\u003e\u003cem\u003eEntamoeba histolytica\u0026nbsp;\u003c/em\u003eFU1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 111px;\"\u003e\n \u003cp\u003e9 (3.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003e11 (3.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 164px;\"\u003e\n \u003cp\u003e2.07 (0.72-5.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 62px;\"\u003e\n \u003cp\u003e0.18\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 211px;\"\u003e\n \u003cp\u003e\u003cem\u003eEntamoeba histolytica\u0026nbsp;\u003c/em\u003eFU2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 111px;\"\u003e\n \u003cp\u003e11 (4.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003e23 (7.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 164px;\"\u003e\n \u003cp\u003e2.73 (0.76-9.76)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 62px;\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eCLTS, Community-led total sanitation; FU, Follow-up; STH, Soil-transmitted helminth; ND, Not determined\u003c/p\u003e\n\u003cp\u003eDiagnostic approaches: * Kato-katz; \u0026nbsp;\u0026quot;Urine filtration; ^Ether-concentration method\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmed","sideBox":"Learn more about [BMC Medicine](http://bmcmedicine.biomedcentral.com/)","snPcode":"12916","submissionUrl":"https://submission.nature.com/new-submission/12916/3","title":"BMC Medicine","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Cluster randomised trial, community-led total sanitation, Côte d’Ivoire, helminths, intestinal protozoa, reinfection","lastPublishedDoi":"10.21203/rs.3.rs-9191647/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9191647/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eParasitic infections remain an important public health problem in low- and middle-income countries. Preventive chemotherapy is the main strategy to control helminthiasis, but rapid reinfection occurs in settings that lack clean water, sanitation and hygiene. This study aimed to assess the effectiveness of community-led total sanitation (CLTS) with or without health education on infections with soil-transmitted helminths, schistosomes and intestinal protozoa.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eWe conducted a longitudinal, repeated cross-sectional cluster-randomised trial within 56 communities in C\u0026ocirc;te d\u0026rsquo;Ivoire. Households that had at least one child aged 5\u0026ndash;15 years were eligible. After a baseline parasitological and knowledge, attitudes, practice and behaviour (KAPB) questionnaire survey, villages were randomly assigned 1:1:1:1 to one of the four groups: (i) CLTS; (ii) health education; (iii) both interventions combined; and (iv) no intervention. All communities received annual preventive chemotherapy. Two follow-up surveys at 17 and 38 months post-intervention assessed the effects of the interventions on primary (infection with any soil-transmitted helminth species) or secondary (infection with schistosomes and intestinal protozoa) outcomes. The primary analysis compared the effect of CLTS on hookworm infection status.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eParticipants were recruited in August and September 2014. Fifty-four localities with 1,246 households including 5,230 participants were randomised, as follow: 13 villages to CLTS, 14 villages to health education, 13 villages to both and 14 villages to no intervention. No significant differences were observed in terms of hookworm prevalence in CLTS and control villages for both follow-up surveys: (i) follow-up at 17 months [59/1,552 (3.8%) vs 69/1,594 (4.3%); odds ratio (OR)\u0026thinsp;=\u0026thinsp;0.87, 95% confidence interval (CI) 0.45 to 1.68, p\u0026thinsp;=\u0026thinsp;0.69] and follow-up at 38 months [26/1,212 (2.1%) vs 24/1,278 (1.9%); OR 1.15, 95% CI 0.60 to 2.17, p\u0026thinsp;=\u0026thinsp;0.68]. Subgroup analysis using localities that achieved at least 75% latrine coverage vs no-CLTS localities, revealed no specific differences in reinfection.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eOur study highlights that the effectiveness of CLTS interventions in preventing helminth and intestinal protozoa infections varies. CLTS may be effective if the baseline prevalence is high but the synergistic effect when combined with regular preventive chemotherapy appears to be limited in this setting.\u003c/p\u003e\u003ch2\u003eTrial Registration\u003c/h2\u003e \u003cp\u003eISRCTN53102033\u003c/p\u003e","manuscriptTitle":"Effectiveness of community-led total sanitation and health education against helminth infections in Côte d’Ivoire: a cluster-randomised factorial trial with 38 months of follow-up","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-19 12:04:17","doi":"10.21203/rs.3.rs-9191647/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-05-03T15:35:59+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"96839200996261163853388580436742438761","date":"2026-04-20T08:40:27+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-09T10:09:23+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-23T11:56:45+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-23T11:23:22+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medicine","date":"2026-03-22T13:37:50+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmed","sideBox":"Learn more about [BMC Medicine](http://bmcmedicine.biomedcentral.com/)","snPcode":"12916","submissionUrl":"https://submission.nature.com/new-submission/12916/3","title":"BMC Medicine","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"df824532-7d3b-4b6e-bdfe-3c205d23ab57","owner":[],"postedDate":"April 19th, 2026","published":true,"recentEditorialEvents":[{"type":"editorInvitedReview","content":"","date":"2026-05-03T15:35:59+00:00","index":34,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-19T12:04:17+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-19 12:04:17","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9191647","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9191647","identity":"rs-9191647","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}