Evaluating Short-Term Changes in Helminth Burdens Using Sequential Community- Based Surveys in Rwanda

Evaluating Short-Term Changes in Helminth Burdens Using Sequential Community- Based Surveys in Rwanda | 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 Article Evaluating Short-Term Changes in Helminth Burdens Using Sequential Community- Based Surveys in Rwanda Ladislas Nshimiyimana, Nadine Rujeni, Aimable Mbituyumuremyi, and 10 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7840120/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 16 Feb, 2026 Read the published version in Scientific Reports → Version 1 posted 11 You are reading this latest preprint version Abstract Despite sustained national mass drug administration (MDA) efforts, soil-transmitted helminths (STHs) and Schistosomiasis remain endemic in Rwanda. This study aimed to evaluate short-term changes in infection prevalence and intensity, identify persistent hotspots, and assess risk factors associated with ongoing transmission. A community-based cross-sectional survey was conducted six months after a baseline survey and one round of national MDA. Parasitological, sociodemographic and household water, sanitation, and hygiene (WaSH) data were analysed for 2,515 participants across ecologically diverse sentinel sites. Hookworm was the most prevalent STH, particularly among adults, while Ascaris lumbricoides predominated in school-aged children. Overall hookworm prevalence declined from 12.6% to 6.6%, yet total intestinal parasite infection (IPI) prevalence rose slightly from 15.0% to 17.1%. Schistosomiasis prevalence was low by microscopy but substantially higher by CCA. Unimproved drinking water sources, use of untreated human excreta as fertilizer, and increasing age were associated with higher odds of infection. Protective factors included adequate household water storage, longer workplace duration, and literacy. While MDA has stabilized average infection levels, persistent hotspots driven by ecological, occupational, and behavioral factors continue to undermine elimination efforts. Integrated strategies are essential to interrupt transmission and advance toward national elimination goals. Health sciences/Diseases Health sciences/Health care Health sciences/Medical research Biological sciences/Microbiology Health sciences/Risk factors Schistosomiasis soil transmitted helminths sentinel sites WaSH MDA Rwanda Figures Figure 1 Background Soil-transmitted helminths (STHs) and schistosomiasis (SCH) remain endemic across much of sub-Saharan Africa, despite decades of concerted control efforts. These parasitic infections—caused by intestinal nematodes such as Ascaris lumbricoides, Trichuris trichiura , and hookworms, as well as trematodes like Schistosoma sp —are closely associated with poverty, inadequate sanitation, and reliance on unsafe water sources for domestic and agricultural use (1,2). Globally, an estimated 1.5 billion people require preventive interventions against STHs, and at least 240 million are affected by SCH, with the majority residing in low-resource settings (2,3). These infections disproportionately affect children and adolescents, contributing to chronic malnutrition, iron-deficiency anaemia, impaired physical and cognitive development, and reduced educational attainment. In Rwanda, national deworming campaigns have been implemented for over a decade, with school-based mass drug administration (MDA) serving as the cornerstone of the country’s helminth control strategy spatially specified by nationwide prevalence mapping (4). These efforts have yielded measurable reductions in prevalence at the national level. However, transmission remains entrenched in specific districts where environmental exposures and behavioral risk factors persist (5–8). Previous mapping and surveillance studies have revealed marked geographic heterogeneity, with some areas reporting sporadic infections and others experiencing sustained transmission (4,8,9). This variation reflects the influence of local ecological conditions—including proximity to water bodies, irrigation schemes, agricultural practices, and sanitation infrastructure—on parasite and/or vector survival and transmission dynamics (4,5,10) Community-based surveys have provided more granular estimates of parasite burden and have underscored the limitations of MDA when implemented in isolation (11,12). A national reassessment found that S. mansoni prevalence was low when measured by Kato-Katz microscopy but substantially higher when assessed using circulating cathodic antigen (CCA) tests, particularly in communities adjacent to irrigated agro-ecosystems (8,12). STHs were more widely distributed, with hookworm predominating among adults engaged in farming and manual labour (8). These findings of dynamic transmission in time and space, suggest that gains achieved through preventive chemotherapy may be fragile and reversible if focal hotspots are not adequately addressed or if complementary interventions—such as improvements in water, sanitation, and hygiene (WaSH)—are not integrated into control programmes. The persistence of transmission in selected areas and the emerging new hotspots raise critical questions about the long-term effectiveness of current strategies and the adaptive capacity of parasite populations under sustained drug pressure. Sentinel site surveys offer a valuable platform for monitoring short-term changes in prevalence and intensity, identifying persistent hotspots, and evaluating the impact and sustainability of control measures. Repeated assessments are particularly important in contexts where national coverage statistics may obscure localized transmission patterns. By revisiting the same communities within a six-month interval, it becomes possible to detect temporal shifts in infection dynamics and to generate evidence for adaptive, sub-District or community-specific programme refinement. Despite repeated rounds of MDA, both STHs and S. mansoni continue to be reported from multiple communities throughout most districts in Rwanda, with clear evidence of geographic clustering and age-related variation (4). Without systematic monitoring and targeted responses to these persistent foci, national elimination goals may remain unattainable. This study aimed to evaluate the prevalence and intensity of STHs and intestinal SCH at ten sentinel sites in Rwanda, six months after a baseline survey followed by a round of MDA, in order to generate comparative evidence on transmission dynamics, identify persistent hotspots, and inform integrated, context-sensitive interventions to accelerate national progress toward elimination. Results A total of 2,515 individuals from 587 households across ten sentinel villages were included in the final analysis. Participants represented all age categories, PSAC, SAC and adults. Stool and urine samples were successfully collected and examined for STH and SCH using both Kato-Katz and CCA methods for all study participants. The following results present the prevalence and intensity of parasitic infections, stratified by age, sex, and district. Patterns of infection burden are described for individual STH parasite species, Overall STH and SCH alongside total parasite infection (PI). Comparisons of prevalence across demographic groups and geographic areas are provided, followed by temporal trends between the two sequential surveys. Multivariable regression analyses further explored associations between infection status and sociodemographic as well as WASH-related factors. Overall prevalence and demographic distribution To provide an overview of infection burden, prevalence and intensity of parasites were first analyzed by age and sex categories and the results are presented in Table 1. Hookworm was the most common infection, particularly in participants older than 15 years, with higher prevalence among males (12.0%) compared to females (9.4%). Ascaris lumbricoides was found across all age groups, with notable infection intensities in younger males. Schistosoma mansoni infection by the Kato-Katz technique was relatively low but confirmed by the CCA test, which yielded higher prevalence rates, particularly among children aged 5–15 years. Overall, PI and STH prevalence increased with age. Sex-specific prevalence We then examined overall prevalence patterns by sex to assess potential statistical differences in infection risk between males and females. The results are presented in Table 2. Hookworm was the most common parasite, affecting 6.6% of participants overall, with statistically comparable prevalences between females (6.1%) and males (7.2%). Other parasites, including Ascaris lumbricoides (3.9% overall) and Trichuris trichiura (1.6% overall), occurred at lower frequencies, with no statistically significant differences by sex. Schistosomiasis prevalence was also low and comparable between males and females, whether measured by Kato-Katz or CCA test. Total PI and STH infection rates were 17.1% and 11.3%, respectively, with no statistically significant sex differences observed. Age-specific prevalence Age-stratified analyses were conducted to explore how infection prevalence varied across preschool children, school-aged children, and adults. Table 3 presents the age-stratified distribution of parasite infections. Hookworm prevalence was markedly higher in adults (>15 years), reaching 10.6%, compared to only 2.8% in SAC (5–15 years) and absent in PSAC (<5 years) (p < 0.001). Infection intensity followed a similar age trend, with median egg counts highest among adults (p = 0.0012). Ascaris lumbricoides occurred across all age groups but was most common in children aged 5–15 years (4.6%), with significantly higher prevalence compared to adults (3.0%) (p = 0.043). Trichuris trichiura remained relatively rare overall, showing no significant age-related differences. For SCH, prevalence by Kato-Katz was slightly higher in school-aged children (3.2%) than in adults (2.4%), though not statistically significant. The CCA test indicated similar prevalence across all age groups (about 5%), confirming low but widespread transmission. Notably, “other parasites” (e.g., Enterobius vermicularis , Taenia spp.) were significantly more frequent among children (2.1%) than adults (0.5%) (p = 0.001). When grouped, overall PI prevalence increased modestly with age, from 13.3% in children <5 years to 18.3% in adults, although the difference was not statistically significant (p = 0.140). In contrast, total STH prevalence rose sharply with age, from 7.5% in PSAC to 13.9% in adults (p < 0.001). Geographic distribution District-level variations in parasite prevalence and intensity were assessed to identify areas with concentrated transmission and potential hotspots. Statistical comparisons between Districts are presented in Table 4 and geographical illustrations in Figure 1. Gisagara and Nyanza reported the highest hookworm prevalence (12.6% and 16.3%, respectively; p < 0.001). Trichuris infections were concentrated in Karongi (8.1%). Ascaris lumbricoides prevalence was highest in Gisagara (9.1%), while SCH was strongly clustered in Nyanza (15.9% by Kato-Katz, 33.9% by CCA). Overall PI prevalence was highest in Gisagara (24.3%) and Nyanza (49.0%), with correspondingly elevated STH prevalence (21.2% and 19.6%, respectively). Comparison with baseline survey Findings from this follow-up survey were compared with results from the baseline survey conducted six months earlier (8) to evaluate temporal changes in infection dynamics. Table 5 presents a comparison of parasite prevalence and intensity across the baseline and follow-up surveys. Hookworm remained the predominant infection but declined from 12.6% at baseline to 6.6% at follow-up, with light intensities (median 48 EPG). Ascaris lumbricoides prevalence was stable (3.9–7.4% vs. 3.9%), though localized peaks were noted in Gisagara (9.1%), with moderate intensities. Trichuris trichiura prevalence was consistently low (1.6% in both surveys), though Karongi showed higher focal levels (8.1%), with light intensities. Schistosomiasis prevalence remained low by Kato-Katz (2.4% vs. 2.6%), but the CCA test consistently revealed higher prevalence (4.9–7.2% at baseline vs. 5.1% trace-positive and 3.4% trace-negative at follow-up), underscoring the diagnostic gap. Other parasites were rare, occurring in less than 2% of participants in both surveys. Overall, IPI prevalence increased slightly from 15% to 17.1%, while total STH prevalence decreased modestly from 12.6% to 11.3%. Correlates analysis – Any intestinal parasite infection Associations between sociodemographic and WaSH characteristics were explored and the likelihood of any IPI using logistic regression. Bivariate logistic regression analysis revealed that household WaSH factors were strongly associated with intestinal parasitic infection. The presence of a household toilet (OR = 0.33, 95% CI: 0.23–0.48), water storage facilities (OR = 0.33, 95% CI: 0.23–0.47), and the practice of treating drinking water (OR = 0.30, 95% CI: 0.20–0.45) were all protective against infection, each showing highly significant associations (p < 0.001). In contrast, reliance on unimproved sources of drinking water increased the likelihood of infection (OR = 1.13, 95% CI: 1.09–1.18, p < 0.001). Sociodemographic factors such as religion also showed significant associations (OR = 1.19, 95% CI: 1.09–1.29, p < 0.001), suggesting behavioral or cultural influences on exposure risk. In the final multivariable logistic regression model, several predictors remained significantly associated with the outcome. Individuals obtaining drinking water from unimproved sources had higher odds of infection (OR = 1.13, 95% CI: 1.08–1.17, p < 0.001). In contrast, household water storage was strongly protective (OR = 0.32, 95% CI: 0.22–0.45, p < 0.001), and a longer duration spent in the workplace was also associated with reduced odds of infection (OR = 0.67, 95% CI: 0.53–0.83, p < 0.001). Use of human excreta as fertilizer increased the likelihood of infection (OR = 1.35, 95% CI: 1.07–1.71, p = 0.010). Age was an important determinant, with individuals in older age categories having significantly higher odds of infection (OR = 1.27, 95% CI: 1.06–1.53, p = 0.010). Finally, literacy was protective, as those able to read had lower odds of infection compared to non-readers (OR = 0.77, 95% CI: 0.61–0.97, p = 0.030). Together, these results highlight the importance of water access and storage, workplace exposures, agricultural practices, age, and literacy as independent determinants of infection. Correlates analysis – Soil-transmitted helminth infection Separate regression analyses were conducted to identify determinants of STH infection specifically and the findings are presented in Table 7. Bivariate logistic regression showed that several WaSH and demographic factors were significantly associated with STH infection. Households with water storage facilities had substantially reduced odds of infection (OR = 0.32, 95% CI: 0.22–0.45, p < 0.001), and treating drinking water was similarly protective (OR = 0.30, 95% CI: 0.20–0.45, p < 0.001). Reliance on unimproved drinking water sources increased the risk of infection (OR = 1.13, 95% CI: 1.09–1.18, p < 0.001). In addition, prior use of human excreta as fertilizer was associated with higher odds of infection (OR = 1.35, 95% CI: 1.07–1.71, p = 0.01), and older age categories showed a modest but significant increase in risk (OR = 1.27, 95% CI: 1.06–1.53, p = 0.01). In the final multivariable logistic regression model for STH infection, three predictors remained statistically significant. Household water storage was associated with a strong protective effect, with individuals from households that stored water having lower odds of infection (OR = 0.44, 95% CI: 0.22–0.87, p = 0.02). Similarly, a longer duration in workplace was significantly protective (OR = 0.54, 95% CI: 0.42–0.70, p < 0.01). Occupation was also significantly associated with STH infection, with employed individuals overall showing reduced odds compared to the unemployed (OR = 0.86, 95% CI: 0.76–0.98, p = 0.02). Age-related factors did not demonstrate significant associations. Taken together, these results suggest that workplace exposure, household water management, and occupational status are key determinants of STH infection risk, independent of age. Correlates analysis – SCH Finally, predictors of S. mansoni infection were examined to highlight factors contributing to its persistence in focal areas. The results are presented in Table 8. Bivariate logistic regression analysis identified several predictors significantly associated with SCH. Household water and sanitation conditions were strongly linked to infection status. For example, the presence of a household toilet, water storage, and treatment of drinking water were each associated with substantially lower odds of infection, while reliance on unimproved drinking water sources significantly increased infection risk. Sociodemographic characteristics also showed associations. Age categories demonstrated increased odds of infection compared with younger participants, and occupation was significantly associated with SCH risk, suggesting differential exposure related to livelihood activities. In the multivariable logistic regression analysis, several predictors remained independently associated with SCH. Increasing age was associated with slightly lower odds of infection (OR = 0.98, 95% CI: 0.96–1.00, p = 0.030). Access to clean water within 500 meters of the household reduced the likelihood of infection by more than half (OR = 0.48, 95% CI: 0.24–0.95, p = 0.040), and households with water storage facilities had a marked reduction in risk (OR = 0.07, 95% CI: 0.01–0.53, p = 0.010). By contrast, reliance on unsafe or unimproved drinking water sources was associated with increased infection risk (OR = 1.34, 95% CI: 1.22–1.47, p < 0.001). Furthermore, a history of using human excreta as fertilizer significantly elevated the odds of infection (OR = 2.99, 95% CI: 1.78–5.03, p < 0.001). These findings highlight that water access, storage practices, and agricultural behaviors are strong and independent determinants of SCH transmission, even after adjusting for age. Discussion The current study evaluates the prevalence and intensity of SCH and STH in Rwandan sentinel sites. Comparative analyses allowed the evaluation of changes in infection levels that occurred over six months in the framework of the current national MDA strategies. Potential demographic and WaSH risk factors for infection were also analysed. The results show an overall STH prevalence of 11.3%, with Hookworm the most common infection at 6.6%, followed by A. lumbricoides at 3.9% and T. trichiura at 1.6%. Schistosoma mansoni infection was at 2.6% by the Kato-Katz technique, 5.1% and 3.4% by the CCA when ‘trace’ cases were considered positive or negative respectively. Infection distribution varied significantly across age and geographical location (District). The comparative analysis highlights pockets of enduring transmission. In Gisagara, adult hookworm prevalence remained above 12 percent, and in Nyanza, SCH positivity by CCA reached a remarkable 33.9 percent. The results suggest a stable overall infection burden over the six-month period, but with persistent hotspots. Hookworm remains the principal contributor to STH burden, particularly among adults, while SCH persists in focal areas. These figures parallel patterns observed elsewhere in East Africa. In Kenya, for example, school-based deworming markedly reduced Ascaris lumbricoides burden yet left adult hookworm reservoirs virtually intact (18). Uganda’s FibroScHot trial similarly documented S. mansoni hotspots that persisted despite repeated praziquantel distribution (19). Such regional experiences illustrate how control gains through MDA alone are fragile and underline the need for integrated interventions beyond chemotherapy. The two sentinel surveys, conducted six months apart at the same sites, unlock critical insights into the dynamics of STH and SCH under Rwanda’s long-standing school-based MDA framework and the recent inclusion of adults in MDA. By maintaining consistent methodologies—including dual diagnostics and stratified sampling—the study has not only documented an encouraging decline in overall hookworm prevalence from 12.6 percent to 6.6 percent but also exposed the stubborn persistence of high-burden foci in districts such as Gisagara and Nyanza. In these areas, the combination of adult occupational exposure and environmental suitability for parasite survival has created a fragile equilibrium in which chemotherapy can blunt—but not terminate—transmission. This nuanced understanding underscores the value of sentinel surveillance for capturing heterogeneity that national prevalence surveys may overlook. The discrepancy between Kato-Katz microscopy and CCA testing in our surveys exemplifies a fundamental challenge in schistosomiasis control: underdiagnosis. While Kato-Katz identified S. mansoni eggs in only 2.6 percent of participants, CCA detected antigen in up to 5.1 percent (trace-positive), revealing nearly double the infection burden. Comparable diagnostic gaps have been reported in Côte d’Ivoire (20) and Brazil (21), where CCA and PCR methods consistently outperformed microscopy in low-intensity settings. Moreover, emerging genomic evidence indicates that adult schistosome worms can survive standard praziquantel treatment, retaining reproductive capacity and genetic heterogeneity that perpetuates low-grade transmission (22). Without integrating more sensitive diagnostics into routine monitoring, control programmes risk overestimating progress and under-prioritising persistent hotspots. Age-stratified analysis revealed contrasting transmission niches: Ascaris lumbricoides peaked among school-aged children (4.7 percent prevalence), while hookworm was most prevalent in adults (12.0 percent). This dichotomy reflects the interplay of behavior and biology. Children’s exploratory play, coupled with inadequate handwashing facilities, drives Ascaris exposure, whereas adults engaged in farming or daily labour sustain hookworm transmission through barefoot soil contact. Notably, multivariable regression identified literacy as an independent protective factor—likely through improved health literacy and adoption of preventive behaviors—while use of untreated human excreta as agricultural fertilizer increased odds of any intestinal parasite infection by 35 percent. These findings align with studies from Ethiopia (23) and Madagascar (24), underscoring that both socio-cultural practices and occupational hazards must be addressed to disrupt transmission cycles. Persistent schistosomiasis transmission in districts such as Nyanza illustrates the powerful role of ecological context. Irrigation canals, rice paddies, and fishing ponds create ideal snail habitats, enabling S. mansoni to flourish despite high MDA coverage (10). Similar ecological drivers and farmers/workers behaviour sustained hotspots around Lake Albert in Uganda, where water-contact behaviors and irrigation practices maintained high transmission intensity (25). In Gisagara, it is likely that the clay-rich soils with high organic content may retain moisture, prolonging hookworm larval viability—conditions echoing those documented in Ethiopia (26). These parallels make clear that breaking transmission requires more than drug distribution; it demands targeted environmental interventions such as focal mollusciciding, improved drainage, and community-led ecosystem management. Household water, sanitation, and hygiene practices emerged as critical modulators of infection risk. Participants in households with protected water storage had 68 percent lower odds of any intestinal parasite infection, and those with close access to clean water faced nearly half the risk of S. mansoni . Conversely, households reusing untreated excreta for fertilization saw sharply elevated infection rates. These associations reinforce global meta-analyses demonstrating that integrated WaSH improvements significantly amplify the impact of preventive chemotherapy (27). In Rwanda, our previous work has similarly linked inadequate latrine coverage and unsafe water sources to persistent NTD transmission (8). Addressing these infrastructural and behavioral determinants through community-based sanitation campaigns and hygiene education is therefore essential for achieving durable control. The modest increase in overall PI from 15.0 percent at baseline to 17.1 percent at follow-up underscores the rapid reinfection potential in endemic settings. Reinfection rates for hookworm among adults in Kenya return to pre-treatment levels within weeks, a phenomenon driven by continuous soil exposure and lack of protective footwear (28). Seasonality (rainy vs dry seasons) further amplifies risk by expanding snail habitats and increasing soil moisture, as observed in Madagascar where transmission peaks coincide with the rainy season (24). Moreover, the persistant practice of applying untreated human excreta in agriculture perpetuates soil contamination, creating an environmental reservoir that sustains transmission year-round (8). These cyclical reinfection dynamics illuminate why MDA alone fails to achieve interruption of transmission. The sentinel-survey design constitutes a major strength, offering robust temporal comparisons within the same communities and reducing confounding by site heterogeneity. The large, ecologically stratified sample across seven districts enhances the granularity and subnational generalizability of results. Furthermore, the combined use of Kato-Katz and CCA diagnostics improved detection of low-intensity S. mansoni infections, mitigating underestimation by microscopy alone. Nevertheless, the six-month follow-up period may not capture longer-term seasonal or annual fluctuations, and self-reported WaSH data remain subject to social desirability bias. Sentinel sites, while invaluable for trend analysis, are not fully representative of the national landscape, and the absence of independent MDA coverage verification limits insights into programmatic implementation fidelity. Rwanda’s NTD programme must evolve from a chemotherapy-centric approach to a multisectoral strategy that addresses ecological, social, and behavioral drivers of transmission. The expansion of MDA to include all age groups of which high-risk adult populations may take long to have an impact on infection trends. Routine integration of antigen-based CCA diagnostics will enable more accurate surveillance and hotspot identification. Intensified investment in improved water infrastructure, sanitation facilities, and safe agricultural waste management will reduce environmental transmission reservoirs. Furthermore, targeted snail control interventions and community-led ecosystem modifications are critical for interrupting schistosomiasis cycles. Future research should extend sentinel monitoring across multiple transmission seasons, compare school-based versus community-wide MDA effectiveness, and conduct detailed malacological surveys to map vector distributions across seasons. Such operational and implementation research will guide the development of cost-effective, context-sensitive intervention packages capable of transitioning from morbidity control to sustained elimination. Conclusion The sequential sentinel surveys in Rwanda demonstrate that, although mass drug administration has stabilized helminth prevalence under sustained high coverage, entrenched hotspots driven by adult occupational exposures, favourable ecological niches, and diagnostic blind spots continue to undermine elimination efforts. Achieving lasting interruption of transmission will require a recalibrated, sub-district-specific strategy that complement preventive chemotherapy with enhanced WaSH, environmental management and community engagement in behaviour change. Rwanda’s experience offers a compelling blueprint for other endemic countries seeking to move beyond morbidity control toward the ultimate goal of helminth elimination. Methods Study Design and Setting This study employed a cross-sectional, community-based design, conducted six months after an initial baseline survey at established sentinel sites in Rwanda. The primary objective of the follow-up was to assess short-term changes in the prevalence and intensity of soil-transmitted helminths (STHs) and intestinal schistosomiasis (SCH) following national mass drug administration (MDA) campaigns. Ten administrative villages from Seven districts were purposively selected to reflect a wide spectrum of ecological settings and transmission intensities previously documented through national mapping assessments (4,12). Study Setting and Population Characteristics Fieldwork was conducted across ten administrative villages situated in regions with confirmed endemicity for both SCH and STH. A stratified sampling framework was applied to ensure inclusion of communities with varying degrees of co-endemicity, as delineated in the 2020 nationwide community-based mapping exercise. As described previously (8), schistosomiasis prevalence served as the principal criterion for site selection, ensuring that high-risk areas were adequately represented. Participant recruitment was proportionally aligned with the demographic structure of each village, based on the Rwanda 5th Population and Housing Census (NISR, 2022) (13). The final sample comprised 52% adults (≥16 years), 40.5% school-aged children (SAC, 5–15 years), and 7.5% preschool-aged children (PSAC, 12–59 months). All study sites were located in predominantly rural settings, where subsistence agriculture is the primary livelihood. The selected districts spanned diverse ecological zones, capturing the environmental heterogeneity characteristic of Rwanda’s tropical temperate climate. Sampling Strategy and Site Selection A stratified sampling approach guided the selection of sentinel sites. Initial stratification was based on ecological zones, from which representative districts were purposively chosen. Within each district, villages were categorized according to their documented prevalence of STH and SCH, as reported in the 2020 national mapping survey (12,14). Villages were then randomly selected from each prevalence category. Where endemicity data were unavailable for both STH and SCH, substitutions were made using neighbourhood relationship principles to maintain representativeness. Household and Participant Recruitment In each selected village, a comprehensive household listing was conducted, and unique identifiers were assigned to facilitate computerized random selection. All individuals residing in selected households were eligible for enrolment, regardless of age or sex. This inclusive approach ensured that both pediatric and adult populations were adequately represented in parasitological and survey assessments. Parasitological Assessment Two diagnostic modalities were employed to detect helminth infections. Stool samples from all 2,515 participants were analyzed using the Kato-Katz technique for both STH and SCH, while urine samples from the same individuals were tested for SCH using the Circulating Cathodic Antigen (CCA) rapid assay. For the Kato-Katz procedure, two smears were prepared per participant and examined under light microscopy by trained laboratory personnel blinded to clinical and demographic data (15). Egg counts were recorded for each helminth species to determine infection intensity. Given the rapid degradation of hookworm ova upon exposure to glycerine, initial readings were performed within 20 minutes of slide preparation. Slides were re-examined after 60 minutes to detect other helminth species. All microscopic procedures were subject to external quality assurance by the ISO 15189-accredited National Reference Laboratory. For the CCA test (Batch # 240822067; IDT Diagnostics CC t/a ICT International, South Africa), urine specimens were applied to lateral flow devices and interpreted after 20 minutes in accordance with manufacturer instructions. Band intensity was graded into four semi-quantitative categories—trace, +, ++, and +++—based on previously validated scoring criteria (16). Assessment of Household WaSH Conditions and Demographic Characteristics Household-level water accessibility, sanitation conditions, and hygiene (WaSH) practices, along with demographic characteristics, were assessed using a structured survey tool (see Supplementary Material 1). The tool was adapted from the standardized core questions developed by the WHO/UNICEF Joint Monitoring Programme for WaSH (17) and underwent contextual validation by Rwanda’s National Neglected Tropical Diseases (NTD) Technical Working Group. Given the household-based nature of the assessment, responses were provided by the household head or a designated representative, reflecting conditions applicable to all members. Data collection was conducted electronically via REDCap, with trained enumerators administering the survey through face-to-face interviews. Where feasible, direct observation was used to verify self-reported responses, thereby enhancing data reliability and reducing reporting bias. Statistical Analysis Data analyses were performed in Stata version 15 (StataCorp, College Station, TX, USA) Data were cleaned, and checked for consistency before analysis. Descriptive statistics summarized sociodemographic variables and infection characteristics. Prevalence was calculated as proportions, and infection intensity for helminths was expressed as median eggs per gram (EPG) of stool. Differences in prevalence across sex, age categories, and districts were assessed using Pearson’s chi-square tests, and median egg counts were compared across demographic and geographical strata using the Kruskal Wallis test to examine variation in parasite burden. Age- and sex-specific prevalence patterns were explored to identify demographic trends, while district-level stratification was used to evaluate geographic heterogeneity. For SCH, prevalence was estimated using both Kato-Katz microscopy and the circulating cathodic antigen (CCA) test. All statistical tests were two-sided, with p ≤ 0.05 considered significant. Bivariate logistic regression was used to assess unadjusted associations between each explanatory variable and intestinal parasitic infection status (IPI status), STH status and Schistosoma infection status, all coded as binary outcomes. Variables with p 0.05) were sequentially removed until only significant variables remained. Multicollinearity was evaluated using the variance inflation factor (VIF), with predictors showing VIF > 10 excluded. Model adequacy was confirmed by ensuring convergence and stable confidence intervals. Results are presented as odds ratios (ORs) with 95% confidence intervals (CIs) and associated p-values. Ethics approval and consent to participate The study received approval from the Rwanda National Research Ethics Committee (Approval No. RNEC631/2024). Written informed consent was obtained from all adult participants, and parental or guardian consent was sought for minors, with assent obtained from children aged 7–15 years. All data were anonymized, and confidentiality was maintained through password-protected databases. Participants diagnosed with STH or SCH were treated in line with national guidelines using albendazole or praziquantel, respectively. All procedures were performed in accordance with the Declaration of Helsinki and the national regulations on human research. Declarations Acknowledgments We thank the study participants, laboratory technicians and data collectors. Authors’ contributions LN, NR, EN and ER designed the study, AM, AO, JBM, KP, JU, NH and AT conducted the field work, CM and NR analyzed the data and wrote the first draft, LN, ER, TH, and AO secured funding. All authors reviewed and approved the final version of the manuscript. Data Availability statement All raw data can be provided by the corresponding author on reasonable request. Competing interests None Funding This study was funded by the End Fund through grants provided to its implementing partners, the Rwanda Biomedical Centre (RBC) and Heart and Sole Africa. References Mendes EP, Okhai H, Cristóvão RE, Almeida MC, Katondi N, Thompson R, et al. Mapping of schistosomiasis and soil-transmitted helminthiases across 15 provinces of Angola. PLoS Neglected Tropical Diseases. 2022;16(6):1–14. WHO. Ending-the-neglect-to-attain-the-SDGs--NTD-Roadmap. 2021; Stevens G, Ho J, Fat DM. 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Frontiers in Pediatrics. 2022;10(June):1–7. Nshimiyimana L, Mbituyumuremyi A, Ower A, Mbonigaba JB, Palacio K, Musarurwa C, et al. Water and sanitation factors associated with schistosomiasis and soil transmitted helminthiasis persistence in Rwanda. Scientific Reports. 2025;15(1):1–10. Rujeni N, Morona D, Ruberanziza E, Mazigo HD. Schistosomiasis and soil-transmitted helminthiasis in Rwanda: An update on their epidemiology and control. Infectious Diseases of Poverty. 2017. Kagabo J, Tabo Z, Kalinda C, Nyandwi E, Rujeni N. Schistosomiasis transmission: A machine learning analysis reveals the importance of agrochemicals on snail abundance in Rwanda. PLoS Neglected Tropical Diseases. 2024;18(12):1–15. Kabatende J, Mugisha M, Ntirenganya L, Barry A, Ruberanziza E, Mbonigaba JB, et al. Prevalence, intensity, and correlates of soil-transmitted helminth infections among school children after a decade of preventive chemotherapy in Western Rwanda. Pathogens. 2020;9(12):1–20. 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Casacuberta-Partal M, Hoekstra PT, Kornelis D, van Lieshout L, van Dam GJ. An innovative and user-friendly scoring system for standardised quantitative interpretation of the urine-based point-of-care strip test (POC-CCA) for the diagnosis of intestinal schistosomiasis: a proof-of-concept study. Acta Tropica. 2019;199(August):4–7. WHO and UNICEF. Core questions on water, sanitation and hygiene for household surveys. Jt Monit Program ; 2018;(November):1-24;https://washdata.org/sites/default/files/docu. Mwandawiro CS, Nikolay B, Kihara JH, Ozier O, Mukoko DA, Mwanje MT, et al. Monitoring and evaluating the impact of national school-based deworming in Kenya: Study design and baseline results. Parasites and Vectors. 2013;6(1):1–14. Besigye F, Rowel C, Adriko M, Muyodi FJ, Kisakye JJ, Nalwanga R, et al. School-aged Schistosoma mansoni infection levels after long-term programmatic control show failure to meet control programme targets and evidence of a persistent hotspot: evaluation of the FibroScHot trial baseline data. PLOS Neglected Tropical Diseases. 2025;19(5):1–15. Assaré RK, Tra MBI, Ouattara M, Hürlimann E, Coulibaly JT, N’Goran EK, et al. Sensitivity of the point-of-care circulating cathodic antigen urine cassette test for diagnosis of schistosoma mansoni in low-endemicity settings in Côte d’Ivoire. American Journal of Tropical Medicine and Hygiene. 2018;99(6):1567–72. Bezerra DDF, Pinheiro MCC, Barbosa L, Viana AG, Fujiwara RT, Bezerra FSDM. Diagnostic comparison of stool exam and point-of-care circulating cathodic antigen (POC-CCA) test for schistosomiasis mansoni diagnosis in a high endemicity area in northeastern Brazil. Parasitology. 2021;148(4):420–6. Faust CL, Crotti M, Moses A, Oguttu D, Wamboko A, Adriko M, et al. Two-year longitudinal survey reveals high genetic diversity of Schistosoma mansoni with adult worms surviving praziquantel treatment at the start of mass drug administration in Uganda. Parasites and Vectors. 2019;12(1):1–12. Gurmassa BK, Gari SR, Solomon ET, Goodson ML, Walsh CL, Dessie BK, et al. Prevalence and risk factors of soil transmitted helminths among vegetable farmers of Akaki river bank, Addis Ababa, Ethiopia. BMC Infectious Diseases. 2024;24(1). Rasoamanamihaja CF, Rakotoarivelo RA, Edosoa G, Rasamoelina T, Montresor A, Marchese V, et al. Schistosomiasis elimination in Madagascar: Challenges and opportunities for implementing the new WHO guidelines. BMJ Global Health. 2023;8(8):1–8. Standley CJ, Adriko M, Arinaitwe M, Atuhaire A, Kazibwe F, Fenwick A, et al. Epidemiology and control of intestinal schistosomiasis on the Sesse Islands, Uganda: Integrating malacology and parasitology to tailor local treatment recommendations. Parasites and Vectors. 2010;3(1):1–11. Anegagrie M, Lanfri S, Aramendia AA, Scavuzzo CM, Herrador Z, Benito A, et al. Environmental characteristics around the household and their association with hookworm infection in rural communities from bahir dar, amhara region, Ethiopia. PLoS Neglected Tropical Diseases. 2021;15(6):1–20. Strunz EC, Addiss DG, Stocks ME, Ogden S, Utzinger J, Freeman MC. Water, Sanitation, Hygiene, and Soil-Transmitted Helminth Infection: A Systematic Review and Meta-Analysis. PLoS Medicine. 2014;11(3). Mwandawiro C, Okoyo C, Kihara J, Simiyu E, Kepha S, Campbell SJ, et al. Results of a national school-based deworming programme on soil-transmitted helminths infections and schistosomiasis in Kenya: 2012-2017. Parasites and Vectors. 2019;12(1). Tables Table 1: Age- and sex-specific prevalence and infection intensity in the study population Parasite Species Age Category 15years Female n=97 Male n=91 Female n=531 Male n=488 Female n=725 Male n=583 Hookworm n(%) 0 0 14 (2.6) 14 (2.9) 68 (9.4) 70 (12.0) Intensity EPG* 0 0 36(12-132) 48(24-84) 72(24-180) 48(12-120) Trichuris trichiura n(%) 3 (3.1) 1 (1.1) 6 (1.1) 14 (2.9) 10 (1.4) 7 (1.2) Intensity EPG* 24(12-96) 48(48-48) 60(24-108) 24(12-84 24(12-36) 12(12-60) Ascaris lumbricoides n(%) 6 (6.2) 5 (5.5) 25 (4.7) 22 (4.5) 25 (3.5) 14 (2.4) Intensity EPG* 390(48-684) 2100(540-3972) 120(36-660) 192(84-780) 84(24-360) 582(60-1872) Schistosomiasis (Kato Katz technique) n(%) 0 1 (1.1) 22 (4.1) 11 (2.3) 11 (1.5) 20 (3.4) Intensity EPG* 0 2.5(2.5-2.5) 2.5(1.5-6.5) 1.5(1-3) 2(1-4.5) 2.5(0.8-3.5) Schistosomiasis (Circulating Cathodic Antigen test) With trace as Positive 5 (5.2) 5 (5.5) 33 (6.2) 22 (4.5) 29 (4.0) 34 (5.8) With trace as Negative 4 (4.1) 3 (3.3) 20 (3.8) 15 (3.1) 18 (2.5) 25 (4.30 Other Parasites** n(%) 3 (3.1) 1 (1.1) 10 (1.9) 11 (2.3) 2 (0.30 4 (0.7) Total IPI Status 15 (15.5) 10 (11.0) 85 (16.0) 80 (16.4) 125 (17.2) 115 (19.7) Total STH Status 9(9.3) 5 (5.5) 43 (8.10 45 (9.2) 98 (13.5) 84 (14.4) Key: EPG*: Eggs per Gram as median (Interquartile range); IPI Intestinal parasite infection; STH: Soil transmitted helminths; ** Other parasites include Enterobius vermicularis, Taenia species. Table 2: Overall prevalence and infection intensity by sex Parasite species Overall prevalence n(%) Sex p-value Female n= 1374 n(%) Male n=1187 n(%) Hookworm n(%) 166(6.6) 82(6.1) 84(7.2) 0.239 Intensity EPG* 48(24-120) 72(24-156) 48(24-114) 0.099 Trichuris trichiura n(%) 41(1.6) 19(1.4) 22(1.9) 0.334 Intensity EPG* 24(12-72) 24(12-96) 18(12-72) 0.490 Ascaris lumbricoides n(%) 97(3.9) 56(4.1) 41(3.5) 0.428 Intensity EPG* 180(48-1032) 132(36-648) 240(84-1872) 0.076 Schistosomiasis Kato Katz technique n(%) 65(2.6) 33(2.4) 32(2.8) 0.620 Intensity EPG* 60(24-96) 60(24-144) 54(24-72) 0.630 Schistosomiasis Circulating Cathodic Antigen (CCA) test With trace as Positive 128(5.1) 67(5.0) 61(5.3) 0.738 With Trace as Negative 85(3.4) 42(3.1) 43(3.7) 0.411 Other Parasites** n(%) 31(1.2) 15(1.1) 16(1.4) 0.543 Total IPI Status 430(17.1) 225(16.6) 205(17.7) 0.495 Total STH Status 284(11.3) 150(11.1) 134(11.5) 0.725 Key: EPG*: Eggs per Gram as median (interquartile range); IPI Intestinal parasite infection; STH: Soil transmitted helminths; ** Other parasites include Enterobius vermicularis, Taenia species Table 3: Age-specific prevalence of infection in the study population Parasite species Age Category p- value 15 years n=1308 Hookworm n(%) 0 28(2.8) 138(10.6) <0.001 Intensity EPG* 0 48(24-114) 54(24-132_ 0.0012 Trichuris trichiura n(%) 4(2.1) 20(2.0) 17(1.3) 0.390 Intensity EPG* 36(18-72) 30(12-102) 24(12-36) 0.955 Ascaris lumbricoides n(%) 11(5.9) 47(4.6) 39(3.0) 0.043 Intensity EPG* 540(324-3972) 168(36-780) 156(24-1032) 0.698 Schistosomiasis (Kato Katz technique) n(%) 1(0.5) 33(3.2) 31(2.4) 0.077 Intensity EPG* 60(60-60) 48(24-120) 60(24-96) 0.823 Schistosomiasis (Circulating Cathodic Antigen test) With trace as Positive 10(5.3) 55(5.4) 63(4.8) 0.807 With Trace as Negative 7(3.7) 35(3.4) 43(3.3) 0.945 Other Parasites** n(%) 4(2.1) 21(2.1) 6(0.5) 0.001 Total IPI Status 25(13.3) 165(16.2) 240(18.3) 0.140 Total STH Status 14(7.5) 88(8.6) 182(13.9) <0.001 Key: EPG*: Eggs per Gram as median (interquartile range); IPI Intestinal parasite infection; STH: Soil transmitted helminths; ** Other parasites include Enterobius vermicularis, Taenia species Table 4: Statistical comparisons of prevalence and intensity of infection by district Parasite Species District Gasabo n=270 Gatsibo n=496 Gisagara n=725 Karongi n=272 Kirehe n=256 Nyagatare n=251 Nyanza n=245 p-value Hookworm n(%) 3(1.1) 8(1.6) 80(12.6) 7(2.6) 3(1.2) 14(5.6) 40(16.3) <0.001 Intensity EPG* 12(12-24) 24(12-78) 78(36-192) 72(36-120) 48(36-84) 36(24-96) 36(12-96) 0.011 Trichuris trichiura n(%) 2(0.7) 2(0.4) 8(1.3) 22(8.1) 0 2(0.8) 4(1.6) <0.001 Intensity EPG* 36(24-48) 48(12-84) 18(12-60) 24(12-96) 0 12(12-12) 30(18-36) 0.715 Ascaris lumbricoides n(%) 12(4.4) 7(1.4) 58(9.1) 4(1.5) 1(0.4) 3(1.2) 5(2.0) <0.001 Intensity EPG* 240(12-2496) 24(12-240) 180(48-972) 2208(84-4734) 264(264-264) 36(12-684) 1500(84-6396) 0.447 Schistosomiasis (Kato Katz technique) n(%) 0 0 23(3.6) 0 0 1(0.4) 39(15.9) <0.001 Intensity EPG* 0 0 36(24-60) 0 0 12(12-12) 72(24-144) 0.023 Schistosomiasis (Circulating Cathodic Antigen test) With trace as Positive 18(6.7) 13(2.6) 7(1.1) 0 7(2.7) 0 83(33.9) <0.001 With Trace as Negative 11(4.1) 12(2.4) 5(0.8) 0 5(2.0) 0 52(21.2) <0.001 Other Parasites** n(%) 4(1.5) 1(0.2) 10(1.6) 2(0.7) 7(2.7) 3(1.2) 3(1.2) 0.111 Total IPI Status 36(13.3) 30(6.1) 155(24.3) 33(12.1) 17(6.6) 20(8.0) 120(49.0) <0.001 Total STH Status 16(5.9) 16(3.2) 135(21.2) 31(11.4) 4(1.6) 18(7.2) 48(19.6) <0.001 Key: EPG*: Eggs per Gram as median(Interquartile range); IPI Intestinal parasite infection; STH: Soil transmitted helminths; ** Other parasites include Enterobius vermicularis , Taenia species Table 5: Comparison of Prevalence and infection Intensity Across Two Surveys in Rwanda Parasite species Baseline prevalence Baseline Intensity (EPG) Follow-up prevalence Follow-up intensity (EPG) Hookworm 12.6% overall (higher in >15 years Median 11.4 6.6% overall (1.1-16.3% by district Median (IQR): 48(24-120) Trichuris trichiura 1.6% overall Median: 24 1.6% overall (Up to 8.1% in Karongi Median (IQR): 24(12-72) Ascaris lumbricoides 3.9-7.4% Median: 132 3.9% overall (Up to 9.1% in Gisagara) Median (IQR): 180(48-1032) SCH (Kato Katz) 2.4% overall Median 1.6 2.6% overall (Up to 15.9% in Nyanza) Median (IQR): 60(24-96) SCH (CCA) 4.9-7.2% - 5.1% (Trace as positive) and 3.4% (Trace as negative) Other parasites** <2% 1.2% Total IPI 15% 17.1% Total STH 12.6% 11.3% Key: IQR: Interquartile range; IPI Intestinal parasite infection; STH: Soil transmitted helminths; ** Other parasites include Enterobius vermicularis, Taenia species; SCH: Schistosomiasis; CCA: circulating cathodic antigen; EPG: Eggs per gramme Table 6: Bi-variate and multivariable logistic regression analysis of sociodemographic and WaSH risk factors of any parasite infection. Variable Bivariate Logistic Regression analysis Multivariable Logistic Regression Analysis Crude Odds Ratio p-value Adjusted Odds Ratio p-value Drinking water source 1.14(1.09-1.18) <0.001 1.13(1.08-1.17 <0.001 Adequate household water storage facility 0.33(0.23-0.47 <0.001 0.32(0.22-0.45) <0.001 Household uses water treatment methods 0.30(0.20-0.45) <0.001 - - Household has toilet facilities 0.33(0.23-0.48) <0.001 - - Household toilet quality is acceptable (Door, lid, slab, roof) 0.54(0.39-0.76) 5 hours 0.68(0.56-0.85) <0.001 0.67(0.53-0.83) <0.001 Toilet is available in workplace 0.54(0.38-0.78) 0.001 - - Clean water is available close to homestead 0.69(0.56-0.86) 0.001 - - History of previously using human excreta as fertiliser 1.44(1.14-1.81) 0.002 1.35(1.07-1.71) 0.01 Water for domestic use is available in homestead 0.50(0.31-0.80) 0.004 - - Age 1.19(1.00-1.40) 0.049 1.27(1.06-1.53) 0.01 Education attainment 0.90(0.80-1.00) 0.051 - - Quality toilet in workplace 0.36(0.11-1.21) 0.099 - - Able to read 0.87(0.70-1.07) 0.174 0.77(0.61-0.97) 0.03 Dirty workplace toilet 1.63(0.75-3.55) 0.217 - - Household has hand washing facility 0.72(0.42-1.23) 0.231 - - Able to write 0.88(0.72-1.09) 0.246 - - Table 7: Bi-variate and multivariable logistic regression analysis of sociodemographic and WaSH risk factors of STH infection. Variable Bivariate Logistic Regression analysis Multivariable Logistic Regression Analysis Crude Odds Ratio p-value Adjusted Odds Ratio p-value Age in years 1.01(1.01-1.02) <0.001 1.24(0.90-1.72) 0.19 Duration in work place 0.56(0.43-0.71) <0.001 0.54(0.42-0.70) <0.001 Adequate household water storage facility 0.42(0.28-0.63) <0.001 0.44(0.22-0.87) 0.023 Toilet is available within the homestead 0.46(0.29-0.72) <0.001 - - Occupation 0.77(0.70-0.86) <0.001 0.86(0.76-0.98) 0.021 Water treated in household before use 0.45(0.30-0.69) 30 minutes 1.30(1.01-1.66) 0.043 - - Educational attainment 0.89(0.78-1.02) 0.092 - - Dirty household toilet 0.71(0.47-1.07) 0.102 - - Dirty workplace toilet 1.93(0.88-4.27) 0.104 - - Ability to read 0.82(0.64-1.04) 0.115 - - Current use of human excreta as fertiliser 1.67(0.86-3.24) 0.133 - - Quality workplace toilet 0.41(0.12-1.40) 0.151 - - Religion 1.08(0.97-1.20) 0.162 - - Duration to workplace 1.19(0.93-1.53) 0.174 - - Ability to write 0.85(0.66-1.08) 0.183 - - Table 8: Bi-variate and multivariable logistic regression analysis of sociodemographic and WASH risk factors of intestinal SCH. Variable Bivariate Logistic Regression analysis Multivariable Logistic Regression Analysis Crude Odds Ratio p-value Adjusted Odds Ratio p-value Clean water is close to homestead 0.28(0.15-0.55) <0.001 0.48(0.24-0.95) 0.036 History of using human excreta as fertiliser 4.11(2.49-6.77) <0.001 2.99(1.78-5.030 <0.001 Religion 1.47(1.23-1.76) <0.001 - - Source of drinking water 1.42(1.30-1.55) <0.001 1.34(1.22-1.470 <0.001 Toilet is available within homestead 0.16(0.09-0.29) <0.001 - - Adequate household water storage facility 0.06(0.01-0.46) 0.012 0.07(0.01-0.53) 0.010 Age in years 0.98(0.97-1.00) 0.032 0.98(0.96-1.00) 0.026 Marital status 0.46(0.21-1.01) 0.053 - - Duration to workplace 0.63(0.39-1.04) 0.071 - - Toilet paper and water available in household toilet 2.13(0.94-4.81) 0.073 - - Dirty household toilet 1.72(0.87-3.39) 0.125 - - Water is available in the household 0.35(0.08-1.44) 0.152 - - Education attainment 0.85(0.65-1.11) 0.233 - - Additional Declarations No competing interests reported. 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Fund","correspondingAuthor":false,"prefix":"","firstName":"Eugene","middleName":"","lastName":"Ruberanziza","suffix":""}],"badges":[],"createdAt":"2025-10-12 10:53:11","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7840120/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7840120/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1038/s41598-026-39367-w","type":"published","date":"2026-02-16T15:57:31+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":98778297,"identity":"aed5d75e-c3a7-4f40-897d-c22dac558037","added_by":"auto","created_at":"2025-12-22 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08:50:48","extension":"html","order_by":8,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":171435,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7840120/v1/dd6e7c5e17362006417daf6e.html"},{"id":98747205,"identity":"6da785e7-beb3-4bc0-99a5-250158951ef8","added_by":"auto","created_at":"2025-12-22 08:50:47","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":673120,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eGeographical distribution of STH and SCH\u003c/strong\u003e. Administrative Districts are presented with the prevalence of infection (Hookworm, \u003cem\u003eAscaris lumbricoides, Trichuris trichiura\u003c/em\u003e and Schistosomiasis). Intensity of the colour is proportional to the prevalence but values are different for each species.\u003c/p\u003e","description":"","filename":"Fig1.png","url":"https://assets-eu.researchsquare.com/files/rs-7840120/v1/c7c144ca3bf8b62a7f034d4a.png"},{"id":103252234,"identity":"c3aba04c-7b02-47e5-95cb-629164ee5806","added_by":"auto","created_at":"2026-02-23 16:13:40","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2831676,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7840120/v1/975fa03b-f73d-4ffc-af73-a237518becfe.pdf"},{"id":98777159,"identity":"b4826fca-6eb3-4fc2-b4b1-1fd471848546","added_by":"auto","created_at":"2025-12-22 12:25:31","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":979231,"visible":true,"origin":"","legend":"","description":"","filename":"Questionnaires.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7840120/v1/bbfab0a35917edcc36197cf3.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Evaluating Short-Term Changes in Helminth Burdens Using Sequential Community- Based Surveys in Rwanda","fulltext":[{"header":"Background","content":"\u003cp\u003eSoil-transmitted helminths (STHs) and schistosomiasis (SCH) remain endemic across much of sub-Saharan Africa, despite decades of concerted control efforts. These parasitic infections—caused by intestinal nematodes such as \u003cem\u003eAscaris lumbricoides, Trichuris trichiura\u003c/em\u003e, and hookworms, as well as trematodes like \u003cem\u003eSchistosoma sp\u003c/em\u003e—are closely associated with poverty, inadequate sanitation, and reliance on unsafe water sources for domestic and agricultural use (1,2). Globally, an estimated 1.5 billion people require preventive interventions against STHs, and at least 240 million are affected by SCH, with the majority residing in low-resource settings (2,3). These infections disproportionately affect children and adolescents, contributing to chronic malnutrition, iron-deficiency anaemia, impaired physical and cognitive development, and reduced educational attainment.\u003c/p\u003e\n\u003cp\u003eIn Rwanda, national deworming campaigns have been implemented for over a decade, with school-based mass drug administration (MDA) serving as the cornerstone of the country’s helminth control strategy spatially specified by nationwide prevalence mapping (4). These efforts have yielded measurable reductions in prevalence at the national level. However, transmission remains entrenched in specific districts where environmental exposures and behavioral risk factors persist (5–8). Previous mapping and surveillance studies have revealed marked geographic heterogeneity, with some areas reporting sporadic infections and others experiencing sustained transmission (4,8,9). This variation reflects the influence of local ecological conditions—including proximity to water bodies, irrigation schemes, agricultural practices, and sanitation infrastructure—on parasite and/or vector survival and transmission dynamics (4,5,10)\u003c/p\u003e\n\u003cp\u003eCommunity-based surveys have provided more granular estimates of parasite burden and have underscored the limitations of MDA when implemented in isolation (11,12). A national reassessment found that \u003cem\u003eS. mansoni\u003c/em\u003e prevalence was low when measured by Kato-Katz microscopy but substantially higher when assessed using circulating cathodic antigen (CCA) tests, particularly in communities adjacent to irrigated agro-ecosystems (8,12). STHs were more widely distributed, with hookworm predominating among adults engaged in farming and manual labour (8). These findings of dynamic transmission in time and space, suggest that gains achieved through preventive chemotherapy may be fragile and reversible if focal hotspots are not adequately addressed or if complementary interventions—such as improvements in water, sanitation, and hygiene (WaSH)—are not integrated into control programmes.\u003c/p\u003e\n\u003cp\u003eThe persistence of transmission in selected areas and the emerging new hotspots raise critical questions about the long-term effectiveness of current strategies and the adaptive capacity of parasite populations under sustained drug pressure. Sentinel site surveys offer a valuable platform for monitoring short-term changes in prevalence and intensity, identifying persistent hotspots, and evaluating the impact and sustainability of control measures. Repeated assessments are particularly important in contexts where national coverage statistics may obscure localized transmission patterns. By revisiting the same communities within a six-month interval, it becomes possible to detect temporal shifts in infection dynamics and to generate evidence for adaptive, sub-District or community-specific programme refinement.\u003c/p\u003e\n\u003cp\u003eDespite repeated rounds of MDA, both STHs and \u003cem\u003eS. mansoni\u003c/em\u003e continue to be reported from multiple communities throughout most districts in Rwanda, with clear evidence of geographic clustering and age-related variation (4). Without systematic monitoring and targeted responses to these persistent foci, national elimination goals may remain unattainable. This study aimed to evaluate the prevalence and intensity of STHs and intestinal SCH at ten sentinel sites in Rwanda, six months after a baseline survey followed by a round of MDA, in order to generate comparative evidence on transmission dynamics, identify persistent hotspots, and inform integrated, context-sensitive interventions to accelerate national progress toward elimination.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 2,515 individuals from 587 households across ten sentinel villages were included in the final analysis. Participants represented all age categories, PSAC, SAC and adults. Stool and urine samples were successfully collected and examined for STH and SCH using both Kato-Katz and CCA methods for all study participants.\u003c/p\u003e\n\u003cp\u003eThe following results present the prevalence and intensity of parasitic infections, stratified by age, sex, and district. Patterns of infection burden are described for individual STH parasite species, Overall STH and SCH alongside total parasite infection (PI). Comparisons of prevalence across demographic groups and geographic areas are provided, followed by temporal trends between the two sequential surveys. Multivariable regression analyses further explored associations between infection status and sociodemographic as well as WASH-related factors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOverall prevalence and demographic distribution\u003c/strong\u003e\u003cbr\u003eTo provide an overview of infection burden, prevalence and intensity of parasites were first analyzed by age and sex categories and the results are presented in Table 1. Hookworm was the most common infection, particularly in participants older than 15 years, with higher prevalence among males (12.0%) compared to females (9.4%). \u003cem\u003eAscaris lumbricoides\u003c/em\u003e was found across all age groups, with notable infection intensities in younger males. \u003cem\u003eSchistosoma mansoni\u003c/em\u003e infection by the Kato-Katz technique was relatively low but confirmed by the CCA test, which yielded higher prevalence rates, particularly among children aged 5\u0026ndash;15 years. Overall, PI and STH prevalence increased with age.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSex-specific prevalence\u003c/strong\u003e\u003cbr\u003eWe then examined overall prevalence patterns by sex to assess potential statistical differences in infection risk between males and females. The results are presented in Table 2. Hookworm was the most common parasite, affecting 6.6% of participants overall, with statistically comparable prevalences between females (6.1%) and males (7.2%). Other parasites, including \u003cem\u003eAscaris lumbricoides\u003c/em\u003e (3.9% overall) and \u003cem\u003eTrichuris trichiura\u003c/em\u003e (1.6% overall), occurred at lower frequencies, with no statistically significant differences by sex. Schistosomiasis prevalence was also low and comparable between males and females, whether measured by Kato-Katz or CCA test. Total PI and STH infection rates were 17.1% and 11.3%, respectively, with no statistically significant sex differences observed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAge-specific prevalence\u003c/strong\u003e\u003cbr\u003eAge-stratified analyses were conducted to explore how infection prevalence varied across preschool children, school-aged children, and adults. Table 3 presents the age-stratified distribution of parasite infections. Hookworm prevalence was markedly higher in adults (\u0026gt;15 years), reaching 10.6%, compared to only 2.8% in SAC (5\u0026ndash;15 years) and absent in PSAC (\u0026lt;5 years) (p \u0026lt; 0.001). Infection intensity followed a similar age trend, with median egg counts highest among adults (p = 0.0012). \u003cem\u003eAscaris lumbricoides\u003c/em\u003e occurred across all age groups but was most common in children aged 5\u0026ndash;15 years (4.6%), with significantly higher prevalence compared to adults (3.0%) (p = 0.043). \u003cem\u003eTrichuris trichiura\u003c/em\u003e remained relatively rare overall, showing no significant age-related differences. For SCH, prevalence by Kato-Katz was slightly higher in school-aged children (3.2%) than in adults (2.4%), though not statistically significant. The CCA test indicated similar prevalence across all age groups (about 5%), confirming low but widespread transmission. Notably, \u0026ldquo;other parasites\u0026rdquo; (e.g.,\u0026nbsp;\u003cem\u003eEnterobius vermicularis\u003c/em\u003e, Taenia spp.) were significantly more frequent among children (2.1%) than adults (0.5%) (p = 0.001).\u003cbr\u003e\u0026nbsp;\u003cbr\u003e\u0026nbsp;When grouped, overall PI prevalence increased modestly with age, from 13.3% in children \u0026lt;5 years to 18.3% in adults, although the difference was not statistically significant (p = 0.140). In contrast, total STH prevalence rose sharply with age, from 7.5% in PSAC to 13.9% in adults (p \u0026lt; 0.001).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eGeographic distribution\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;District-level variations in parasite prevalence and intensity were assessed to identify areas with concentrated transmission and potential hotspots. Statistical comparisons between Districts are presented in Table 4 and geographical illustrations in Figure 1.\u003c/p\u003e\n\u003cp\u003eGisagara and Nyanza reported the highest hookworm prevalence (12.6% and 16.3%, respectively; p \u0026lt; 0.001). \u003cem\u003eTrichuris\u003c/em\u003e infections were concentrated in Karongi (8.1%). \u003cem\u003eAscaris lumbricoides\u003c/em\u003e prevalence was highest in Gisagara (9.1%), while SCH was strongly clustered in Nyanza (15.9% by Kato-Katz, 33.9% by CCA). Overall PI prevalence was highest in Gisagara (24.3%) and Nyanza (49.0%), with correspondingly elevated STH prevalence (21.2% and 19.6%, respectively).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eComparison with baseline survey\u003c/strong\u003e\u003cbr\u003eFindings from this follow-up survey were compared with results from the baseline survey conducted six months earlier (8) to evaluate temporal changes in infection dynamics. Table 5 presents a comparison of parasite prevalence and intensity across the baseline and follow-up surveys. Hookworm remained the predominant infection but declined from 12.6% at baseline to 6.6% at follow-up, with light intensities (median 48 EPG). \u003cem\u003eAscaris lumbricoides\u003c/em\u003e prevalence was stable (3.9\u0026ndash;7.4% vs. 3.9%), though localized peaks were noted in Gisagara (9.1%), with moderate intensities. \u003cem\u003eTrichuris trichiura\u003c/em\u003e prevalence was consistently low (1.6% in both surveys), though Karongi showed higher focal levels (8.1%), with light intensities. Schistosomiasis prevalence remained low by Kato-Katz (2.4% vs. 2.6%), but the CCA test consistently revealed higher prevalence (4.9\u0026ndash;7.2% at baseline vs. 5.1% trace-positive and 3.4% trace-negative at follow-up), underscoring the diagnostic gap. Other parasites were rare, occurring in less than 2% of participants in both surveys. Overall, IPI prevalence increased slightly from 15% to 17.1%, while total STH prevalence decreased modestly from 12.6% to 11.3%.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCorrelates analysis \u0026ndash; Any intestinal parasite infection\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Associations between sociodemographic and WaSH characteristics were explored and the likelihood of any IPI using logistic regression. Bivariate logistic regression analysis revealed that household WaSH factors were strongly associated with intestinal parasitic infection. The presence of a household toilet (OR = 0.33, 95% CI: 0.23\u0026ndash;0.48), water storage facilities (OR = 0.33, 95% CI: 0.23\u0026ndash;0.47), and the practice of treating drinking water (OR = 0.30, 95% CI: 0.20\u0026ndash;0.45) were all protective against infection, each showing highly significant associations (p \u0026lt; 0.001). In contrast, reliance on unimproved sources of drinking water increased the likelihood of infection (OR = 1.13, 95% CI: 1.09\u0026ndash;1.18, p \u0026lt; 0.001). Sociodemographic factors such as religion also showed significant associations (OR = 1.19, 95% CI: 1.09\u0026ndash;1.29, p \u0026lt; 0.001), suggesting behavioral or cultural influences on exposure risk.\u003c/p\u003e\n\u003cp\u003eIn the final multivariable logistic regression model, several predictors remained significantly associated with the outcome. Individuals obtaining drinking water from unimproved sources had higher odds of infection (OR = 1.13, 95% CI: 1.08\u0026ndash;1.17, p \u0026lt; 0.001). In contrast, household water storage was strongly protective (OR = 0.32, 95% CI: 0.22\u0026ndash;0.45, p \u0026lt; 0.001), and a longer duration spent in the workplace was also associated with reduced odds of infection (OR = 0.67, 95% CI: 0.53\u0026ndash;0.83, p \u0026lt; 0.001). Use of human excreta as fertilizer increased the likelihood of infection (OR = 1.35, 95% CI: 1.07\u0026ndash;1.71, p = 0.010). Age was an important determinant, with individuals in older age categories having significantly higher odds of infection (OR = 1.27, 95% CI: 1.06\u0026ndash;1.53, p = 0.010). Finally, literacy was protective, as those able to read had lower odds of infection compared to non-readers (OR = 0.77, 95% CI: 0.61\u0026ndash;0.97, p = 0.030). Together, these results highlight the importance of water access and storage, workplace exposures, agricultural practices, age, and literacy as independent determinants of infection.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCorrelates analysis \u0026ndash; Soil-transmitted helminth infection\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Separate regression analyses were conducted to identify determinants of STH infection specifically and the findings are presented in Table 7. Bivariate logistic regression showed that several WaSH and demographic factors were significantly associated with STH infection. Households with water storage facilities had substantially reduced odds of infection (OR = 0.32, 95% CI: 0.22\u0026ndash;0.45, p \u0026lt; 0.001), and treating drinking water was similarly protective (OR = 0.30, 95% CI: 0.20\u0026ndash;0.45, p \u0026lt; 0.001). Reliance on unimproved drinking water sources increased the risk of infection (OR = 1.13, 95% CI: 1.09\u0026ndash;1.18, p \u0026lt; 0.001). In addition, prior use of human excreta as fertilizer was associated with higher odds of infection (OR = 1.35, 95% CI: 1.07\u0026ndash;1.71, p = 0.01), and older age categories showed a modest but significant increase in risk (OR = 1.27, 95% CI: 1.06\u0026ndash;1.53, p = 0.01). In the final multivariable logistic regression model for STH infection, three predictors remained statistically significant. Household water storage was associated with a strong protective effect, with individuals from households that stored water having lower odds of infection (OR = 0.44, 95% CI: 0.22\u0026ndash;0.87, p = 0.02). Similarly, a longer duration in workplace was significantly protective (OR = 0.54, 95% CI: 0.42\u0026ndash;0.70, p \u0026lt; 0.01). Occupation was also significantly associated with STH infection, with employed individuals overall showing reduced odds compared to the unemployed (OR = 0.86, 95% CI: 0.76\u0026ndash;0.98, p = 0.02). Age-related factors did not demonstrate significant associations. Taken together, these results suggest that workplace exposure, household water management, and occupational status are key determinants of STH infection risk, independent of age.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCorrelates analysis \u0026ndash; SCH\u0026nbsp;\u003c/strong\u003e\u003cbr\u003eFinally, predictors of \u003cem\u003eS. mansoni\u003c/em\u003e infection were examined to highlight factors contributing to its persistence in focal areas. The results are presented in Table 8. Bivariate logistic regression analysis identified several predictors significantly associated with SCH. Household water and sanitation conditions were strongly linked to infection status. For example, the presence of a household toilet, water storage, and treatment of drinking water were each associated with substantially lower odds of infection, while reliance on unimproved drinking water sources significantly increased infection risk. Sociodemographic characteristics also showed associations. Age categories demonstrated increased odds of infection compared with younger participants, and occupation was significantly associated with SCH risk, suggesting differential exposure related to livelihood activities.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn the multivariable logistic regression analysis, several predictors remained independently associated with SCH. Increasing age was associated with slightly lower odds of infection (OR = 0.98, 95% CI: 0.96\u0026ndash;1.00, p = 0.030). Access to clean water within 500 meters of the household reduced the likelihood of infection by more than half (OR = 0.48, 95% CI: 0.24\u0026ndash;0.95, p = 0.040), and households with water storage facilities had a marked reduction in risk (OR = 0.07, 95% CI: 0.01\u0026ndash;0.53, p = 0.010). By contrast, reliance on unsafe or unimproved drinking water sources was associated with increased infection risk (OR = 1.34, 95% CI: 1.22\u0026ndash;1.47, p \u0026lt; 0.001). Furthermore, a history of using human excreta as fertilizer significantly elevated the odds of infection (OR = 2.99, 95% CI: 1.78\u0026ndash;5.03, p \u0026lt; 0.001). These findings highlight that water access, storage practices, and agricultural behaviors are strong and independent determinants of SCH transmission, even after adjusting for age.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe current study evaluates the prevalence and intensity of SCH and STH in Rwandan sentinel sites. Comparative analyses allowed the evaluation of changes in infection levels that occurred over six months in the framework of the current national MDA strategies. Potential demographic and WaSH risk factors for infection were also analysed.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe results show an overall STH prevalence of 11.3%, with Hookworm the most common infection at 6.6%, followed by \u003cem\u003eA. lumbricoides\u003c/em\u003e at 3.9% and \u003cem\u003eT. trichiura\u003c/em\u003e at 1.6%. \u003cem\u003eSchistosoma mansoni\u003c/em\u003e infection was at 2.6% by the Kato-Katz technique, 5.1% and 3.4% by the CCA when ‘trace’ cases were considered positive or negative respectively. Infection distribution varied significantly across age and geographical location (District).\u003c/p\u003e\n\u003cp\u003eThe comparative analysis highlights pockets of enduring transmission. In Gisagara, adult hookworm prevalence remained above 12 percent, and in Nyanza, SCH positivity by CCA reached a remarkable 33.9 percent. The results suggest a stable overall infection burden over the six-month period, but with persistent hotspots. Hookworm remains the principal contributor to STH burden, particularly among adults, while SCH persists in focal areas. These figures parallel patterns observed elsewhere in East Africa. In Kenya, for example, school-based deworming markedly reduced \u003cem\u003eAscaris lumbricoides\u003c/em\u003e burden yet left adult hookworm reservoirs virtually intact (18). Uganda’s FibroScHot trial similarly documented \u003cem\u003eS. mansoni\u003c/em\u003e hotspots that persisted despite repeated praziquantel distribution (19). Such regional experiences illustrate how control gains through MDA alone are fragile and underline the need for integrated interventions beyond chemotherapy.\u003c/p\u003e\n\u003cp\u003eThe two sentinel surveys, conducted six months apart at the same sites, unlock critical insights into the dynamics of STH and SCH under Rwanda’s long-standing school-based MDA framework and the recent inclusion of adults in MDA. By maintaining consistent methodologies—including dual diagnostics and stratified sampling—the study has not only documented an encouraging decline in overall hookworm prevalence from 12.6 percent to 6.6 percent but also exposed the stubborn persistence of high-burden foci in districts such as Gisagara and Nyanza. In these areas, the combination of adult occupational exposure and environmental suitability for parasite survival has created a fragile equilibrium in which chemotherapy can blunt—but not terminate—transmission. This nuanced understanding underscores the value of sentinel surveillance for capturing heterogeneity that national prevalence surveys may overlook.\u003c/p\u003e\n\u003cp\u003eThe discrepancy between Kato-Katz microscopy and CCA testing in our surveys exemplifies a fundamental challenge in schistosomiasis control: underdiagnosis. While Kato-Katz identified \u003cem\u003eS. mansoni\u003c/em\u003e eggs in only 2.6 percent of participants, CCA detected antigen in up to 5.1 percent (trace-positive), revealing nearly double the infection burden. Comparable diagnostic gaps have been reported in Côte d’Ivoire (20) and Brazil (21), where CCA and PCR methods consistently outperformed microscopy in low-intensity settings. Moreover, emerging genomic evidence indicates that adult schistosome worms can survive standard praziquantel treatment, retaining reproductive capacity and genetic heterogeneity that perpetuates low-grade transmission (22). Without integrating more sensitive diagnostics into routine monitoring, control programmes risk overestimating progress and under-prioritising persistent hotspots.\u003c/p\u003e\n\u003cp\u003eAge-stratified analysis revealed contrasting transmission niches: \u003cem\u003eAscaris lumbricoides\u003c/em\u003e peaked among school-aged children (4.7 percent prevalence), while hookworm was most prevalent in adults (12.0 percent). This dichotomy reflects the interplay of behavior and biology. Children’s exploratory play, coupled with inadequate handwashing facilities, drives \u003cem\u003eAscaris\u003c/em\u003e exposure, whereas adults engaged in farming or daily labour sustain hookworm transmission through barefoot soil contact. Notably, multivariable regression identified literacy as an independent protective factor—likely through improved health literacy and adoption of preventive behaviors—while use of untreated human excreta as agricultural fertilizer increased odds of any intestinal parasite infection by 35 percent. These findings align with studies from Ethiopia (23) and Madagascar (24), underscoring that both socio-cultural practices and occupational hazards must be addressed to disrupt transmission cycles.\u003c/p\u003e\n\u003cp\u003ePersistent schistosomiasis transmission in districts such as Nyanza illustrates the powerful role of ecological context. Irrigation canals, rice paddies, and fishing ponds create ideal snail habitats, enabling \u003cem\u003eS. mansoni\u0026nbsp;\u003c/em\u003eto flourish despite high MDA coverage (10). Similar ecological drivers and farmers/workers behaviour sustained hotspots around Lake Albert in Uganda, where water-contact behaviors and irrigation practices maintained high transmission intensity (25). In Gisagara, it is likely that the clay-rich soils with high organic content may retain moisture, prolonging hookworm larval viability—conditions echoing those documented in Ethiopia (26). These parallels make clear that breaking transmission requires more than drug distribution; it demands targeted environmental interventions such as focal mollusciciding, improved drainage, and community-led ecosystem management.\u003c/p\u003e\n\u003cp\u003eHousehold water, sanitation, and hygiene practices emerged as critical modulators of infection risk. Participants in households with protected water storage had 68 percent lower odds of any intestinal parasite infection, and those with close access to clean water faced nearly half the risk of \u003cem\u003eS. mansoni\u003c/em\u003e. Conversely, households reusing untreated excreta for fertilization saw sharply elevated infection rates. These associations reinforce global meta-analyses demonstrating that integrated WaSH improvements significantly amplify the impact of preventive chemotherapy (27). In Rwanda, our previous work has similarly linked inadequate latrine coverage and unsafe water sources to persistent NTD transmission (8). Addressing these infrastructural and behavioral determinants through community-based sanitation campaigns and hygiene education is therefore essential for achieving durable control.\u003c/p\u003e\n\u003cp\u003eThe modest increase in overall PI from 15.0 percent at baseline to 17.1 percent at follow-up underscores the rapid reinfection potential in endemic settings. Reinfection rates for hookworm among adults in Kenya return to pre-treatment levels within weeks, a phenomenon driven by continuous soil exposure and lack of protective footwear (28). Seasonality (rainy vs dry seasons) further amplifies risk by expanding snail habitats and increasing soil moisture, as observed in Madagascar where transmission peaks coincide with the rainy season (24). Moreover, the persistant practice of applying untreated human excreta in agriculture perpetuates soil contamination, creating an environmental reservoir that sustains transmission year-round (8). These cyclical reinfection dynamics illuminate why MDA alone fails to achieve interruption of transmission.\u003c/p\u003e\n\u003cp\u003eThe sentinel-survey design constitutes a major strength, offering robust temporal comparisons within the same communities and reducing confounding by site heterogeneity. The large, ecologically stratified sample across seven districts enhances the granularity and subnational generalizability of results. Furthermore, the combined use of Kato-Katz and CCA diagnostics improved detection of low-intensity \u003cem\u003eS. mansoni\u003c/em\u003e infections, mitigating underestimation by microscopy alone. Nevertheless, the six-month follow-up period may not capture longer-term seasonal or annual fluctuations, and self-reported WaSH data remain subject to social desirability bias. Sentinel sites, while invaluable for trend analysis, are not fully representative of the national landscape, and the absence of independent MDA coverage verification limits insights into programmatic implementation fidelity.\u003c/p\u003e\n\u003cp\u003eRwanda’s NTD programme must evolve from a chemotherapy-centric approach to a multisectoral strategy that addresses ecological, social, and behavioral drivers of transmission. The expansion of MDA to include all age groups of which high-risk adult populations may take long to have an impact on infection trends. Routine integration of antigen-based CCA diagnostics will enable more accurate surveillance and hotspot identification. Intensified investment in improved water infrastructure, sanitation facilities, and safe agricultural waste management will reduce environmental transmission reservoirs. Furthermore, targeted snail control interventions and community-led ecosystem modifications are critical for interrupting schistosomiasis cycles. Future research should extend sentinel monitoring across multiple transmission seasons, compare school-based versus community-wide MDA effectiveness, and conduct detailed malacological surveys to map vector distributions across seasons. Such operational and implementation research will guide the development of cost-effective, context-sensitive intervention packages capable of transitioning from morbidity control to sustained elimination.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe sequential sentinel surveys in Rwanda demonstrate that, although mass drug administration has stabilized helminth prevalence under sustained high coverage, entrenched hotspots driven by adult occupational exposures, favourable ecological niches, and diagnostic blind spots continue to undermine elimination efforts. Achieving lasting interruption of transmission will require a recalibrated, sub-district-specific strategy that complement preventive chemotherapy with enhanced WaSH, environmental management and community engagement in behaviour change. Rwanda\u0026rsquo;s experience offers a compelling blueprint for other endemic countries seeking to move beyond morbidity control toward the ultimate goal of helminth elimination.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy Design and Setting\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study employed a cross-sectional, community-based design, conducted six months after an initial baseline survey at established sentinel sites in Rwanda. The primary objective of the follow-up was to assess short-term changes in the prevalence and intensity of soil-transmitted helminths (STHs) and intestinal schistosomiasis (SCH) following national mass drug administration (MDA) campaigns. Ten administrative villages from Seven districts were purposively selected to reflect a wide spectrum of ecological settings and transmission intensities previously documented through national mapping assessments (4,12).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy Setting and Population Characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFieldwork was conducted across ten administrative villages situated in regions with confirmed endemicity for both SCH and STH. A stratified sampling framework was applied to ensure inclusion of communities with varying degrees of co-endemicity, as delineated in the 2020 nationwide community-based mapping exercise. As described previously (8), schistosomiasis prevalence served as the principal criterion for site selection, ensuring that high-risk areas were adequately represented. Participant recruitment was proportionally aligned with the demographic structure of each village, based on the Rwanda 5th Population and Housing Census (NISR, 2022) (13). The final sample comprised 52% adults (≥16 years), 40.5% school-aged children (SAC, 5–15 years), and 7.5% preschool-aged children (PSAC, 12–59 months). All study sites were located in predominantly rural settings, where subsistence agriculture is the primary livelihood. The selected districts spanned diverse ecological zones, capturing the environmental heterogeneity characteristic of Rwanda’s tropical temperate climate.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSampling Strategy and Site Selection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA stratified sampling approach guided the selection of sentinel sites. Initial stratification was based on ecological zones, from which representative districts were purposively chosen. Within each district, villages were categorized according to their documented prevalence of STH and SCH, as reported in the 2020 national mapping survey (12,14). Villages were then randomly selected from each prevalence category. Where endemicity data were unavailable for both STH and SCH, substitutions were made using neighbourhood relationship principles to maintain representativeness.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eHousehold and Participant Recruitment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn each selected village, a comprehensive household listing was conducted, and unique identifiers were assigned to facilitate computerized random selection. All individuals residing in selected households were eligible for enrolment, regardless of age or sex. This inclusive approach ensured that both pediatric and adult populations were adequately represented in parasitological and survey assessments.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eParasitological Assessment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTwo diagnostic modalities were employed to detect helminth infections. Stool samples from all 2,515 participants were analyzed using the Kato-Katz technique for both STH and SCH, while urine samples from the same individuals were tested for SCH using the Circulating Cathodic Antigen (CCA) rapid assay.\u003c/p\u003e\n\u003cp\u003eFor the Kato-Katz procedure, two smears were prepared per participant and examined under light microscopy by trained laboratory personnel blinded to clinical and demographic data (15). Egg counts were recorded for each helminth species to determine infection intensity. Given the rapid degradation of hookworm ova upon exposure to glycerine, initial readings were performed within 20 minutes of slide preparation. Slides were re-examined after 60 minutes to detect other helminth species. All microscopic procedures were subject to external quality assurance by the ISO 15189-accredited National Reference Laboratory.\u003c/p\u003e\n\u003cp\u003eFor the CCA test (Batch # 240822067; IDT Diagnostics CC t/a ICT International, South Africa), urine specimens were applied to lateral flow devices and interpreted after 20 minutes in accordance with manufacturer instructions. Band intensity was graded into four semi-quantitative categories—trace, +, ++, and +++—based on previously validated scoring criteria (16).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAssessment of Household WaSH Conditions and Demographic Characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eHousehold-level water accessibility, sanitation conditions, and hygiene (WaSH) practices, along with demographic characteristics, were assessed using a structured survey tool (see Supplementary Material 1). The tool was adapted from the standardized core questions developed by the WHO/UNICEF Joint Monitoring Programme for WaSH (17) and underwent contextual validation by Rwanda’s National Neglected Tropical Diseases (NTD) Technical Working Group. Given the household-based nature of the assessment, responses were provided by the household head or a designated representative, reflecting conditions applicable to all members. Data collection was conducted electronically via REDCap, with trained enumerators administering the survey through face-to-face interviews. Where feasible, direct observation was used to verify self-reported responses, thereby enhancing data reliability and reducing reporting bias.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData analyses were performed in Stata version 15 (StataCorp, College Station, TX, USA) Data were cleaned, and checked for consistency before analysis. Descriptive statistics summarized sociodemographic variables and infection characteristics. Prevalence was calculated as proportions, and infection intensity for helminths was expressed as median eggs per gram (EPG) of stool. Differences in prevalence across sex, age categories, and districts were assessed using Pearson’s chi-square tests, and median egg counts were compared across demographic and geographical strata using the Kruskal Wallis test to examine variation in parasite burden. Age- and sex-specific prevalence patterns were explored to identify demographic trends, while district-level stratification was used to evaluate geographic heterogeneity. For SCH, prevalence was estimated using both Kato-Katz microscopy and the circulating cathodic antigen (CCA) test. All statistical tests were two-sided, with p ≤ 0.05 considered significant.\u003c/p\u003e\n\u003cp\u003eBivariate logistic regression was used to assess unadjusted associations between each explanatory variable and intestinal parasitic infection status (IPI status), STH status and \u003cem\u003eSchistosoma\u003c/em\u003e infection status, all coded as binary outcomes. Variables with p \u0026lt; 0.25 in the bivariate analyses were included in a multivariable logistic regression model constructed using backward elimination. Non-significant predictors (p \u0026gt; 0.05) were sequentially removed until only significant variables remained. Multicollinearity was evaluated using the variance inflation factor (VIF), with predictors showing VIF \u0026gt; 10 excluded. Model adequacy was confirmed by ensuring convergence and stable confidence intervals. Results are presented as odds ratios (ORs) with 95% confidence intervals (CIs) and associated p-values.\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eThe study received approval from the Rwanda National Research Ethics Committee (Approval No. RNEC631/2024). Written informed consent was obtained from all adult participants, and parental or guardian consent was sought for minors, with assent obtained from children aged 7–15 years. All data were anonymized, and confidentiality was maintained through password-protected databases. Participants diagnosed with STH or SCH were treated in line with national guidelines using albendazole or praziquantel, respectively. All procedures were performed in accordance with the Declaration of Helsinki and the national regulations on human research.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe thank the study participants, laboratory technicians and data collectors.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors’ contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLN, NR, EN and ER designed the study, AM, AO, JBM, KP, JU, NH and AT conducted the field work, CM and NR analyzed the data and wrote the first draft, LN, ER, TH, and AO secured funding. All authors reviewed and approved the final version of the manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability statement\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll raw data can be provided by the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was funded by the End Fund through grants provided to its implementing partners, the Rwanda Biomedical Centre (RBC) and Heart and Sole Africa.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eMendes EP, Okhai H, Crist\u0026oacute;v\u0026atilde;o RE, Almeida MC, Katondi N, Thompson R, et al. Mapping of schistosomiasis and soil-transmitted helminthiases across 15 provinces of Angola. PLoS Neglected Tropical Diseases. 2022;16(6):1\u0026ndash;14. \u003c/li\u003e\n\u003cli\u003eWHO. Ending-the-neglect-to-attain-the-SDGs--NTD-Roadmap. 2021; \u003c/li\u003e\n\u003cli\u003eStevens G, Ho J, Fat DM. WHO methods and data sourcesfor global burden of disease estimates2000-2021. 2024;(May):1\u0026ndash;48. \u003c/li\u003e\n\u003cli\u003eNshimiyimana L, Mbonigaba JB, Mbituyumuremyi A, Ower A, Hakizimana D, Nyandwi E, et al. Remapping parasite landscapes: Nationwide prevalence, intensity and risk factors of schistosomiasis and soil-transmitted helminthiasis in Rwanda. PLoS neglected tropical diseases. 2025;19(8):e0013328. \u003c/li\u003e\n\u003cli\u003eKagabo J, Kalinda C, Nshimiyimana P, Mbonigaba JB, Ruberanziza E, Nyandwi E, et al. Malacological Survey and Spatial Distribution of Intermediate Host Snails in Schistosomiasis Endemic Districts of Rwanda. 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Infectious Diseases of Poverty. 2017. \u003c/li\u003e\n\u003cli\u003eKagabo J, Tabo Z, Kalinda C, Nyandwi E, Rujeni N. Schistosomiasis transmission: A machine learning analysis reveals the importance of agrochemicals on snail abundance in Rwanda. PLoS Neglected Tropical Diseases. 2024;18(12):1\u0026ndash;15. \u003c/li\u003e\n\u003cli\u003eKabatende J, Mugisha M, Ntirenganya L, Barry A, Ruberanziza E, Mbonigaba JB, et al. Prevalence, intensity, and correlates of soil-transmitted helminth infections among school children after a decade of preventive chemotherapy in Western Rwanda. Pathogens. 2020;9(12):1\u0026ndash;20. \u003c/li\u003e\n\u003cli\u003eRuberanziza E, Wittmann U, Mbituyumuremyi A, Mutabazi A, Campbell CH, Colley DG, et al. Nationwide remapping of Schistosoma mansoni infection in Rwanda using circulating cathodic antigen rapid test: Taking steps toward elimination. American Journal of Tropical Medicine and Hygiene. 2020;103(1):315\u0026ndash;24. \u003c/li\u003e\n\u003cli\u003eNational Institute of Statistics of Rwanda. Population size, Structure and Spatial Distribution. 2022. \u003c/li\u003e\n\u003cli\u003eRuberanziza E, Owada K, Clark NJ, Umulisa I, Ortu G, Lancaster W, et al. Mapping soil-transmitted helminth parasite infection in Rwanda: Estimating endemicity and identifying at-risk populations. Tropical Medicine and Infectious Disease. 2019; \u003c/li\u003e\n\u003cli\u003eBarbosa CS, Gomes ECS, Marcelino JMR, Cavalcante KRLJ, Nascimento WRC. Quality control of the slides by Kato-Katz method for the parasitological diagnosis of schistosomiasis infection by Schistosoma mansoni. Jornal Brasileiro de Patologia e Medicina Laboratorial. 2017;53(2):110\u0026ndash;4. \u003c/li\u003e\n\u003cli\u003eCasacuberta-Partal M, Hoekstra PT, Kornelis D, van Lieshout L, van Dam GJ. 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Parasitology. 2021;148(4):420\u0026ndash;6. \u003c/li\u003e\n\u003cli\u003eFaust CL, Crotti M, Moses A, Oguttu D, Wamboko A, Adriko M, et al. Two-year longitudinal survey reveals high genetic diversity of Schistosoma mansoni with adult worms surviving praziquantel treatment at the start of mass drug administration in Uganda. Parasites and Vectors. 2019;12(1):1\u0026ndash;12. \u003c/li\u003e\n\u003cli\u003eGurmassa BK, Gari SR, Solomon ET, Goodson ML, Walsh CL, Dessie BK, et al. Prevalence and risk factors of soil transmitted helminths among vegetable farmers of Akaki river bank, Addis Ababa, Ethiopia. BMC Infectious Diseases. 2024;24(1). \u003c/li\u003e\n\u003cli\u003eRasoamanamihaja CF, Rakotoarivelo RA, Edosoa G, Rasamoelina T, Montresor A, Marchese V, et al. Schistosomiasis elimination in Madagascar: Challenges and opportunities for implementing the new WHO guidelines. BMJ Global Health. 2023;8(8):1\u0026ndash;8. \u003c/li\u003e\n\u003cli\u003eStandley CJ, Adriko M, Arinaitwe M, Atuhaire A, Kazibwe F, Fenwick A, et al. Epidemiology and control of intestinal schistosomiasis on the Sesse Islands, Uganda: Integrating malacology and parasitology to tailor local treatment recommendations. Parasites and Vectors. 2010;3(1):1\u0026ndash;11. \u003c/li\u003e\n\u003cli\u003eAnegagrie M, Lanfri S, Aramendia AA, Scavuzzo CM, Herrador Z, Benito A, et al. Environmental characteristics around the household and their association with hookworm infection in rural communities from bahir dar, amhara region, Ethiopia. PLoS Neglected Tropical Diseases. 2021;15(6):1\u0026ndash;20. \u003c/li\u003e\n\u003cli\u003eStrunz EC, Addiss DG, Stocks ME, Ogden S, Utzinger J, Freeman MC. Water, Sanitation, Hygiene, and Soil-Transmitted Helminth Infection: A Systematic Review and Meta-Analysis. PLoS Medicine. 2014;11(3). \u003c/li\u003e\n\u003cli\u003eMwandawiro C, Okoyo C, Kihara J, Simiyu E, Kepha S, Campbell SJ, et al. Results of a national school-based deworming programme on soil-transmitted helminths infections and schistosomiasis in Kenya: 2012-2017. Parasites and Vectors. 2019;12(1).\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable 1: Age- and sex-specific prevalence and infection intensity in the study population\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eParasite Species\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 806px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge Category\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 257px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;5 years\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 265px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e5-15years\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026gt;15years\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 135px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFemale\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=97\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMale\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=91\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFemale\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=531\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMale\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=488\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFemale\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=725\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMale\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=583\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 926px;\"\u003e\n \u003cp\u003eHookworm\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003en(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 135px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e14 (2.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e14 (2.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e68 (9.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e70 (12.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eIntensity EPG*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 135px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e36(12-132)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e48(24-84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e72(24-180)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e48(12-120)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 926px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eTrichuris trichiura\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003en(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 135px;\"\u003e\n \u003cp\u003e3 (3.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e1 (1.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e6 (1.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e14 (2.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e10 (1.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e7 (1.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eIntensity EPG*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 135px;\"\u003e\n \u003cp\u003e24(12-96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e48(48-48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e60(24-108)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e24(12-84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e24(12-36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e12(12-60)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 926px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eAscaris lumbricoides\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003en(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 135px;\"\u003e\n \u003cp\u003e6 (6.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e5 (5.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e25 (4.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e22 (4.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e25 (3.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e14 (2.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eIntensity EPG*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 135px;\"\u003e\n \u003cp\u003e390(48-684)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e2100(540-3972)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e120(36-660)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e192(84-780)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e84(24-360)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e582(60-1872)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 926px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSchistosomiasis (Kato Katz technique)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003en(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 135px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e1 (1.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e22 (4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e11 (2.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e11 (1.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e20 (3.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eIntensity EPG*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 135px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e2.5(2.5-2.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e2.5(1.5-6.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1.5(1-3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e2(1-4.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e2.5(0.8-3.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 926px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSchistosomiasis\u003cem\u003e\u0026nbsp;\u003c/em\u003e(Circulating Cathodic Antigen test)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eWith trace as Positive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 135px;\"\u003e\n \u003cp\u003e5 (5.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e5 (5.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e33 (6.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e22 (4.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e29 (4.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e34 (5.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eWith trace as Negative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 135px;\"\u003e\n \u003cp\u003e4 (4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e3 (3.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e20 (3.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e15 (3.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e18 (2.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e25 (4.30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 926px;\"\u003e\n \u003cp\u003eOther Parasites**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003en(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 135px;\"\u003e\n \u003cp\u003e3 (3.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e1 (1.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e10 (1.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e11 (2.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e2 (0.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e4 (0.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eTotal IPI Status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 135px;\"\u003e\n \u003cp\u003e15 (15.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e10 (11.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e85 (16.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e80 (16.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e125 (17.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e115 (19.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eTotal STH Status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 135px;\"\u003e\n \u003cp\u003e9(9.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e5 (5.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e43 (8.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e45 (9.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e98 (13.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e84 (14.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eKey:\u003c/strong\u003e EPG*: Eggs per Gram as median (Interquartile range); IPI Intestinal parasite infection; STH: Soil transmitted helminths; ** Other parasites include Enterobius vermicularis, Taenia species.\u003c/p\u003e\n\u003cp\u003eTable 2: Overall prevalence and infection intensity by sex\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 190px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eParasite species\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 177px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eOverall prevalence n(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 377px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\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 valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFemale n= 1374\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMale n=1187\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 930px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHookworm\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 190px;\"\u003e\n \u003cp\u003en(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 177px;\"\u003e\n \u003cp\u003e166(6.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e82(6.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e84(7.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e0.239\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 190px;\"\u003e\n \u003cp\u003eIntensity EPG*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 177px;\"\u003e\n \u003cp\u003e48(24-120)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e72(24-156)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e48(24-114)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e0.099\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 930px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eTrichuris trichiura\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 190px;\"\u003e\n \u003cp\u003en(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 177px;\"\u003e\n \u003cp\u003e41(1.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e19(1.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e22(1.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e0.334\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 190px;\"\u003e\n \u003cp\u003eIntensity EPG*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 177px;\"\u003e\n \u003cp\u003e24(12-72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e24(12-96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e18(12-72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e0.490\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 930px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eAscaris lumbricoides\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 190px;\"\u003e\n \u003cp\u003en(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 177px;\"\u003e\n \u003cp\u003e97(3.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e56(4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e41(3.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e0.428\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 190px;\"\u003e\n \u003cp\u003eIntensity EPG*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 177px;\"\u003e\n \u003cp\u003e180(48-1032)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e132(36-648)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e240(84-1872)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e0.076\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 930px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSchistosomiasis Kato Katz technique\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 190px;\"\u003e\n \u003cp\u003en(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 177px;\"\u003e\n \u003cp\u003e65(2.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e33(2.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e32(2.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e0.620\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 190px;\"\u003e\n \u003cp\u003eIntensity EPG*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 177px;\"\u003e\n \u003cp\u003e60(24-96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e60(24-144)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e54(24-72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e0.630\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 930px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSchistosomiasis Circulating Cathodic Antigen (CCA) test\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 190px;\"\u003e\n \u003cp\u003eWith trace as Positive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 177px;\"\u003e\n \u003cp\u003e128(5.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e67(5.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e61(5.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e0.738\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 190px;\"\u003e\n \u003cp\u003eWith Trace as Negative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 177px;\"\u003e\n \u003cp\u003e85(3.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e42(3.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e43(3.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e0.411\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 930px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOther Parasites**\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 190px;\"\u003e\n \u003cp\u003en(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 177px;\"\u003e\n \u003cp\u003e31(1.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e15(1.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e16(1.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e0.543\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 190px;\"\u003e\n \u003cp\u003eTotal IPI Status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 177px;\"\u003e\n \u003cp\u003e430(17.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e225(16.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e205(17.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e0.495\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 190px;\"\u003e\n \u003cp\u003eTotal STH Status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 177px;\"\u003e\n \u003cp\u003e284(11.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e150(11.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 188px;\"\u003e\n \u003cp\u003e134(11.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e0.725\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eKey:\u003c/strong\u003e EPG*: Eggs per Gram as median (interquartile range); IPI Intestinal parasite infection; STH: Soil transmitted helminths; ** Other parasites include Enterobius vermicularis, Taenia species\u003c/p\u003e\n\u003cp\u003eTable 3: Age-specific prevalence of infection in the study population\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eParasite species\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 558px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge Category\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\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 valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;5 years\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=188\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e5-15 years\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=1019\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026gt;15 years\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=1308\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 930px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHookworm\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003en(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e28(2.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e138(10.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003eIntensity EPG*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e48(24-114)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e54(24-132_\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.0012\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 930px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eTrichuris trichiura\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003en(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e4(2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e20(2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e17(1.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e0.390\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003eIntensity EPG*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e36(18-72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e30(12-102)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e24(12-36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e0.955\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 930px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eAscaris lumbricoides\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003en(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e11(5.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e47(4.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e39(3.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.043\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003eIntensity EPG*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e540(324-3972)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e168(36-780)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e156(24-1032)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e0.698\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 930px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSchistosomiasis\u003cem\u003e\u0026nbsp;\u003c/em\u003e(Kato Katz technique)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003en(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e1(0.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e33(3.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e31(2.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e0.077\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003eIntensity EPG*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e60(60-60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e48(24-120)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e60(24-96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e0.823\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 930px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSchistosomiasis\u003cem\u003e\u0026nbsp;\u003c/em\u003e(Circulating Cathodic Antigen test)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003eWith trace as Positive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e10(5.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e55(5.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e63(4.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e0.807\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003eWith Trace as Negative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e7(3.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e35(3.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e43(3.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e0.945\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 930px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOther Parasites**\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003en(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e4(2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e21(2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e6(0.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal IPI Status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e25(13.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e165(16.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e240(18.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e0.140\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal STH Status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e14(7.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e88(8.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e182(13.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eKey:\u003c/strong\u003e EPG*: Eggs per Gram as median (interquartile range); IPI Intestinal parasite infection; STH: Soil transmitted helminths; ** Other parasites include Enterobius vermicularis, Taenia species\u003c/p\u003e\n\u003cp\u003eTable 4: \u0026nbsp;Statistical comparisons of prevalence and intensity of infection by district\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eParasite Species\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 656px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDistrict\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGasabo\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=270\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGatsibo\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=496\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGisagara\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=725\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKarongi\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=272\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKirehe\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=256\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNyagatare\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=251\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNyanza\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en=245\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\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 colspan=\"9\" valign=\"top\" style=\"width: 930px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHookworm\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003en(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e3(1.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e8(1.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e80(12.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e7(2.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e3(1.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e14(5.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e40(16.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eIntensity EPG*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e12(12-24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e24(12-78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e78(36-192)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e72(36-120)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e48(36-84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e36(24-96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e36(12-96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.011\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" valign=\"top\" style=\"width: 930px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eTrichuris trichiura\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003en(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e2(0.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e2(0.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e8(1.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e22(8.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e2(0.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e4(1.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eIntensity EPG*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e36(24-48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e48(12-84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e18(12-60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e24(12-96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e12(12-12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e30(18-36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e0.715\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" valign=\"top\" style=\"width: 930px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eAscaris lumbricoides\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003en(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e12(4.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e7(1.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e58(9.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e4(1.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e1(0.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e3(1.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e5(2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eIntensity EPG*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e240(12-2496)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e24(12-240)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e180(48-972)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e2208(84-4734)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e264(264-264)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e36(12-684)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e1500(84-6396)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e0.447\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" valign=\"top\" style=\"width: 930px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSchistosomiasis (Kato Katz technique)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003en(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e23(3.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e1(0.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e39(15.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eIntensity EPG*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e36(24-60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e12(12-12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e72(24-144)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.023\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" valign=\"top\" style=\"width: 930px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSchistosomiasis (Circulating Cathodic Antigen test)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eWith trace as Positive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e18(6.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e13(2.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e7(1.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e7(2.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e83(33.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eWith Trace as Negative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e11(4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e12(2.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e5(0.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e5(2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e52(21.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" valign=\"top\" style=\"width: 930px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOther Parasites**\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003en(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e4(1.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1(0.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e10(1.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e2(0.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e7(2.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e3(1.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e3(1.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e0.111\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal IPI Status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e36(13.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e30(6.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e155(24.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e33(12.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e17(6.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e20(8.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e120(49.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal STH Status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e16(5.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e16(3.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e135(21.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e31(11.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e4(1.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e18(7.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e48(19.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eKey:\u003c/strong\u003e EPG*: Eggs per Gram as median(Interquartile range); IPI Intestinal parasite infection; STH: Soil transmitted helminths; ** Other parasites include \u003cem\u003eEnterobius vermicularis\u003c/em\u003e, Taenia species\u003c/p\u003e\n\u003cp\u003eTable 5: Comparison of Prevalence and infection Intensity Across Two Surveys in Rwanda\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eParasite species\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBaseline prevalence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBaseline Intensity (EPG)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFollow-up prevalence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 212px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFollow-up intensity (EPG)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003eHookworm\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e12.6% overall (higher in \u0026gt;15 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eMedian 11.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e6.6% overall (1.1-16.3% by district\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 212px;\"\u003e\n \u003cp\u003eMedian (IQR): 48(24-120)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e\u003cem\u003eTrichuris trichiura\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e1.6% overall\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eMedian: 24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e1.6% overall (Up to 8.1% in Karongi\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 212px;\"\u003e\n \u003cp\u003eMedian (IQR): 24(12-72)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e\u003cem\u003eAscaris lumbricoides\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e3.9-7.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eMedian: 132\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e3.9% overall (Up to 9.1% in Gisagara)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 212px;\"\u003e\n \u003cp\u003eMedian (IQR): 180(48-1032)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003eSCH (Kato Katz)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e2.4% overall\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eMedian 1.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e2.6% overall (Up to 15.9% in Nyanza)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 212px;\"\u003e\n \u003cp\u003eMedian (IQR): 60(24-96)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003eSCH (CCA)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e4.9-7.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e5.1% (Trace as positive) and 3.4% (Trace as negative)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 212px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003eOther parasites**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e\u0026lt;2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e1.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 212px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003eTotal IPI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e15%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e17.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 212px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003eTotal STH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e12.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e11.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 212px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eKey: IQR: Interquartile range; IPI Intestinal parasite infection; STH: Soil transmitted helminths; ** Other parasites \u003cem\u003einclude Enterobius vermicularis, Taenia\u003c/em\u003e species; SCH: Schistosomiasis; CCA: circulating cathodic antigen; EPG: Eggs per gramme\u003c/p\u003e\n\u003cp\u003eTable 6: Bi-variate and multivariable logistic regression analysis of sociodemographic and WaSH risk factors of any parasite infection.\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 265px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBivariate Logistic Regression analysis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 240px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMultivariable Logistic Regression Analysis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCrude Odds Ratio\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdjusted Odds Ratio\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\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 valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eDrinking water source\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.14(1.09-1.18)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.13(1.08-1.17\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eAdequate household water storage facility\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.33(0.23-0.47\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.32(0.22-0.45)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eHousehold uses water treatment methods\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.30(0.20-0.45)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eHousehold has toilet facilities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.33(0.23-0.48)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eHousehold toilet quality is acceptable (Door, lid, slab, roof)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.54(0.39-0.76)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eDuration in workplace \u0026gt;5 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.68(0.56-0.85)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.67(0.53-0.83)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eToilet is available in workplace\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.54(0.38-0.78)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eClean water is available close to homestead\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.69(0.56-0.86)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eHistory of previously using human excreta as fertiliser\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.44(1.14-1.81)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.002\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.35(1.07-1.71)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eWater for domestic use is available in homestead\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.50(0.31-0.80)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.004\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.19(1.00-1.40)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.049\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.27(1.06-1.53)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eEducation attainment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0.90(0.80-1.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.051\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eQuality toilet in workplace\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0.36(0.11-1.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.099\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eAble to read\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0.87(0.70-1.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.174\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.77(0.61-0.97)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.03\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eDirty workplace toilet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1.63(0.75-3.55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.217\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eHousehold has hand washing facility\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0.72(0.42-1.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.231\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eAble to write\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0.88(0.72-1.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.246\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 7: Bi-variate and multivariable logistic regression analysis of sociodemographic and WaSH risk factors of STH infection.\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" class=\"fr-table-selection-hover\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 265px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBivariate Logistic Regression analysis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 240px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMultivariable Logistic Regression Analysis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCrude Odds Ratio\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdjusted Odds Ratio\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\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 valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eAge in years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.01(1.01-1.02)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e1.24(0.90-1.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e0.19\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eDuration in work place\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.56(0.43-0.71)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.54(0.42-0.70)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eAdequate household water storage facility\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.42(0.28-0.63)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.44(0.22-0.87)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.023\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eToilet is available within the homestead\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.46(0.29-0.72)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eOccupation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.77(0.70-0.86)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.86(0.76-0.98)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.021\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eWater treated in household before use\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.45(0.30-0.69)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.86(0.42-1.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e0.68\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eHousehold toilet is of good quality\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.58(0.39-0.87)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.010\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eWater is available in the household\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.46(0.26-0.84)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.010\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eDuration to water point \u0026gt;30 minutes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.30(1.01-1.66)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.043\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eEducational attainment\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0.89(0.78-1.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.092\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eDirty household toilet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0.71(0.47-1.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.102\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eDirty workplace toilet\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1.93(0.88-4.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eAbility to read\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0.82(0.64-1.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.115\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eCurrent use of human excreta as fertiliser\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1.67(0.86-3.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.133\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eQuality workplace toilet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0.41(0.12-1.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.151\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eReligion\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1.08(0.97-1.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.162\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eDuration to workplace\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1.19(0.93-1.53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.174\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eAbility to write\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0.85(0.66-1.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.183\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 8: Bi-variate and multivariable logistic regression analysis of sociodemographic and WASH risk factors of intestinal SCH.\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 265px;\"\u003e\n \u003cp\u003eBivariate Logistic Regression analysis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 240px;\"\u003e\n \u003cp\u003eMultivariable Logistic Regression Analysis\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eCrude Odds Ratio\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eAdjusted Odds Ratio\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eClean water is close to homestead\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.28(0.15-0.55)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.48(0.24-0.95)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.036\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eHistory of using human excreta as fertiliser\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e4.11(2.49-6.77)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.99(1.78-5.030\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eReligion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.47(1.23-1.76)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eSource of drinking water\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.42(1.30-1.55)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.34(1.22-1.470\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eToilet is available within homestead\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.16(0.09-0.29)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eAdequate household water storage facility\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.06(0.01-0.46)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.012\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.07(0.01-0.53)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.010\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eAge in years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.98(0.97-1.00)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.032\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.98(0.96-1.00)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.026\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eMarital status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0.46(0.21-1.01)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.053\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eDuration to workplace\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0.63(0.39-1.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.071\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eToilet paper and water available in household toilet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e2.13(0.94-4.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.073\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eDirty household toilet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1.72(0.87-3.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.125\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eWater is available in the household\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0.35(0.08-1.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.152\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 425px;\"\u003e\n \u003cp\u003eEducation attainment\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0.85(0.65-1.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.233\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Schistosomiasis, soil transmitted helminths, sentinel sites, WaSH, MDA, Rwanda","lastPublishedDoi":"10.21203/rs.3.rs-7840120/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7840120/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eDespite sustained national mass drug administration (MDA) efforts, soil-transmitted helminths (STHs) and Schistosomiasis\u003cem\u003e \u003c/em\u003eremain endemic in Rwanda. This study aimed to evaluate short-term changes in infection prevalence and intensity, identify persistent hotspots, and assess risk factors associated with ongoing transmission.\u003c/p\u003e\n\u003cp\u003eA community-based cross-sectional survey was conducted six months after a baseline survey and one round of national MDA. Parasitological, sociodemographic and household water, sanitation, and hygiene (WaSH) data were analysed for 2,515 participants across ecologically diverse sentinel sites.\u003c/p\u003e\n\u003cp\u003eHookworm was the most prevalent STH, particularly among adults, while \u003cem\u003eAscaris lumbricoides\u003c/em\u003e predominated in school-aged children. Overall hookworm prevalence declined from 12.6% to 6.6%, yet total intestinal parasite infection (IPI) prevalence rose slightly from 15.0% to 17.1%. Schistosomiasis prevalence was low by microscopy but substantially higher by CCA. Unimproved drinking water sources, use of untreated human excreta as fertilizer, and increasing age were associated with higher odds of infection. Protective factors included adequate household water storage, longer workplace duration, and literacy.\u003c/p\u003e\n\u003cp\u003eWhile MDA has stabilized average infection levels, persistent hotspots driven by ecological, occupational, and behavioral factors continue to undermine elimination efforts. Integrated strategies are essential to interrupt transmission and advance toward national elimination goals.\u003c/p\u003e","manuscriptTitle":"Evaluating Short-Term Changes in Helminth Burdens Using Sequential Community- Based Surveys in Rwanda","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-22 08:50:42","doi":"10.21203/rs.3.rs-7840120/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-01-19T05:14:22+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-07T23:26:09+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-31T06:33:03+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"294794474321333840081077607853552680722","date":"2025-12-17T23:36:30+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"113734223880958726300694811481672303699","date":"2025-12-17T21:26:26+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"23213324393952280857651229998148612571","date":"2025-12-11T19:07:05+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-12-11T16:07:26+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-10-24T17:02:26+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-17T09:53:28+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-16T08:26:04+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2025-10-16T08:22:29+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"30ba4350-5986-48e4-adc7-5c78aa6cf329","owner":[],"postedDate":"December 22nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":59523543,"name":"Health sciences/Diseases"},{"id":59523544,"name":"Health sciences/Health care"},{"id":59523545,"name":"Health sciences/Medical research"},{"id":59523546,"name":"Biological sciences/Microbiology"},{"id":59523547,"name":"Health sciences/Risk factors"}],"tags":[],"updatedAt":"2026-02-23T16:10:38+00:00","versionOfRecord":{"articleIdentity":"rs-7840120","link":"https://doi.org/10.1038/s41598-026-39367-w","journal":{"identity":"scientific-reports","isVorOnly":false,"title":"Scientific Reports"},"publishedOn":"2026-02-16 15:57:31","publishedOnDateReadable":"February 16th, 2026"},"versionCreatedAt":"2025-12-22 08:50:42","video":"","vorDoi":"10.1038/s41598-026-39367-w","vorDoiUrl":"https://doi.org/10.1038/s41598-026-39367-w","workflowStages":[]},"version":"v1","identity":"rs-7840120","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7840120","identity":"rs-7840120","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}