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Article ; Online: Comparative reconstruction of SARS-CoV-2 transmission in three African countries using a mathematical model integrating immunity data.

Naffeti, Bechir / BenAribi, Walid / Kebir, Amira / Diarra, Maryam / Schoenhals, Matthieu / Vigan-Womas, Inès / Dellagi, Koussay / BenMiled, Slimane

IJID regions

2023 Volume 10, Page(s) 100–107

Abstract: Objectives: Africa has experienced fewer COVID-19 cases and deaths than other regions, with a contrasting epidemiological situation between countries, raising questions regarding the determinants of disease spread in Africa.: Methods: We built a ... ...

Abstract	Objectives: Africa has experienced fewer COVID-19 cases and deaths than other regions, with a contrasting epidemiological situation between countries, raising questions regarding the determinants of disease spread in Africa. Methods: We built a susceptible-exposed-infected-recovered model including COVID-19 mortality data where recovery class is structured by specific immunization and modeled by a partial differential equation considering the opposed effects of immunity decline and immunization. This model was applied to Tunisia, Senegal, and Madagascar. Results: Senegal and Tunisia experienced two epidemic phases. Initially, infections emerged in naive individuals and were limited by social distancing. Variants of concern (VOCs) were also introduced. The second phase was characterized by successive epidemic waves driven by new VOCs that escaped host immunity. Meanwhile, Madagascar demonstrated a different profile, characterized by longer intervals between epidemic waves, increasing the pool of susceptible individuals who had lost their protective immunity. The impact of vaccination on model parameters in Tunisia and Senegal was evaluated. Conclusions: Loss of immunity and vaccination-induced immunity have played crucial role in controlling the African pandemic. SARS-CoV-2 has become endemic now and will continue to circulate in African populations. However, previous infections provide significant protection against severe diseases, thus providing a basis for future vaccination strategies.
Language	English
Publishing date	2023-11-23
Publishing country	England
Document type	Journal Article
ISSN	2772-7076
ISSN (online)	2772-7076
DOI	10.1016/j.ijregi.2023.11.011
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Comparative Reconstruction of SARS-CoV-2 transmission in three African countries using a mathematical model integrating immunity data

Naffeti, Bechir / BenAribi, Walid / Kebir, Amira / Diara, Maryam / Schoenhals, Matthieu / Vigan-Womas, Inès / Dellagi, Koussay / BenMiled, Slimane

medRxiv

Abstract: Objectives: Africa has experienced fewer coronavirus disease 2019 (COVID-19) cases and deaths than other regions, with a contrasting epidemiological situation between countries, raising questions regarding the determinants of disease spread in Africa. ... ...

Abstract	Objectives: Africa has experienced fewer coronavirus disease 2019 (COVID-19) cases and deaths than other regions, with a contrasting epidemiological situation between countries, raising questions regarding the determinants of disease spread in Africa. Method: We built a susceptible-exposed-infected-recovered model including COVID-19 mortality data where recovery class is structured by specific immunization and modeled by a partial differential equation considering the opposed effects of immunity decline and immunization. This model was applied to Tunisia, Senegal, and Madagascar. Finding: Senegal and Tunisia experienced two epidemic phases. Initially, infections emerged in naive individuals and were limited by social distancing. Variants of concern (VOCs) were also introduced. The second phase was characterized by successive epidemic waves driven by new VOCs that escaped host immunity. Meanwhile, Madagascar demonstrated a different profile, characterized by longer intervals between epidemic waves, increasing the pool of susceptible individuals who had lost their protective immunity. The impact of vaccination in Tunisia and Senegal on model parameters was evaluated. Interpretation: Loss of immunity and vaccination-induced immunity have played crucial role in controlling the African pandemic. Severe acute respiratory syndrome coronavirus 2 has become endemic now and will continue to circulate in African populations. However, previous infections provide significant protection against severe diseases, thus providing a basis for future vaccination strategies.
Keywords	covid19
Language	English
Publishing date	2023-07-08
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2023.07.07.23292215
Database	COVID19

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Article ; Online: Comparative Reconstruction of SARS-CoV-2 transmission in three African countries using a mathematical model integrating immunity data.

neffeti, bechir / kebir, amira / ben aribi, walid / Diarra, Maryam / schoenhals, matthieu / vigan-womas, ines / dellagi, koussay / ben miled, slimane

medRxiv

Abstract	Objectives: Africa has experienced fewer coronavirus disease 2019 (COVID-19) cases and deaths than other regions, with a contrasting epidemiological situation between countries, raising questions regarding the determinants of disease spread in Africa. Method: We built a susceptible-exposed-infected-recovered model including COVID-19 mortality data where recovery class is structured by specific immunization and modeled by a partial differential equation considering the opposed effects of immunity decline and immunization. This model was applied to Tunisia, Senegal, and Madagascar. Finding: Senegal and Tunisia experienced two epidemic phases. Initially, infections emerged in naive individuals and were limited by social distancing. Variants of concern (VOCs) were also introduced. The second phase was characterized by successive epidemic waves driven by new VOCs that escaped host immunity. Meanwhile, Madagascar demonstrated a different profile, characterized by longer intervals between epidemic waves, increasing the pool of susceptible individuals who had lost their protective immunity. The impact of vaccination in Tunisia and Senegal on model parameters was evaluated. Interpretation: Loss of immunity and vaccination-induced immunity have played crucial role in controlling the African pandemic. Severe acute respiratory syndrome coronavirus 2 has become endemic now and will continue to circulate in African populations. However, previous infections provide significant protection against severe diseases, thus providing a basis for future vaccination strategies.
Keywords	covid19
Language	English
Publishing date	2023-07-08
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2023.07.07.23292215
Database	COVID19

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Article: Two mosquito salivary antigens demonstrate promise as biomarkers of recent exposure to

medRxiv : the preprint server for health sciences

2024

Abstract: Background: Measuring malaria transmission intensity using the traditional entomological inoculation rate is difficult. Antibody responses to mosquito salivary proteins such as SG6 have previously been used as biomarkers of exposure to : Methods: We ... ...

Abstract	Background: Measuring malaria transmission intensity using the traditional entomological inoculation rate is difficult. Antibody responses to mosquito salivary proteins such as SG6 have previously been used as biomarkers of exposure to Methods: We tested population-level human immune responses in longitudinal and cross-sectional plasma samples from individuals with known Results: AgSAP and AgTRIO were the best indicators of recent exposure to infected mosquitoes. Antibody responses to AgSAP, in a moderate endemic area, and to AgTRIO in both low and moderate endemic areas, were significantly higher than responses in a healthy non-endemic control cohort (p-values = 0.0245, 0.0064, and <0.0001 respectively). No antibody responses significantly differed between the low and moderate transmission area, or between equivalent groups during and outside the malaria transmission seasons. For AgSAP and AgTRIO, reactivity peaked 2-4 weeks after clinical Discussion: Reactivity to both AgSAP and AgTRIO peaked after infection and did not differ seasonally nor between areas of low and moderate transmission, suggesting reactivity is likely reflective of exposure to infectious mosquitos or recent biting rather than general mosquito exposure. Kinetics suggest reactivity is relatively short-lived. AgSAP and AgTRIO are promising candidates to incorporate into multiplexed assays for serosurveillance of population-level changes in
Language	English
Publishing date	2024-04-22
Publishing country	United States
Document type	Preprint
DOI	10.1101/2024.04.20.24305430
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Article ; Online: Unveiling P. vivax invasion pathways in Duffy-negative individuals.

Bouyssou, Isabelle / El Hoss, Sara / Doderer-Lang, Cécile / Schoenhals, Matthieu / Rasoloharimanana, Lova Tsikiniaina / Vigan-Womas, Inès / Ratsimbasoa, Arsène / Abate, Andargie / Golassa, Lemu / Mabilotte, Solenne / Kessler, Pascal / Guillotte-Blisnick, Micheline / Martinez, Francisco J / Chitnis, Chetan E / Strouboulis, John / Ménard, Didier

Cell host & microbe

2023 Volume 31, Issue 12, Page(s) 2080–2092.e5

Abstract: Vivax malaria has long been thought to be absent from sub-Saharan Africa owing to the high proportion of individuals lacking the Duffy antigen receptor for chemokines (DARC) in their erythrocytes. The interaction between P. vivax Duffy-binding protein ( ... ...

Abstract	Vivax malaria has long been thought to be absent from sub-Saharan Africa owing to the high proportion of individuals lacking the Duffy antigen receptor for chemokines (DARC) in their erythrocytes. The interaction between P. vivax Duffy-binding protein (PvDBP) and DARC is assumed to be the main pathway used by merozoites to invade reticulocytes. However, the increasing number of reports of vivax malaria cases in genotypically Duffy-negative (DN) individuals has raised questions regarding the P. vivax invasion pathway(s). Here, we show that a subset of DN erythroblasts transiently express DARC during terminal erythroid differentiation and that P. vivax merozoites, irrespective of their origin, can invade DARC+ DN erythroblasts. These findings reveal that a large number of DN individuals may represent a silent reservoir of deep P. vivax infections at the sites of active erythropoiesis with low or no parasitemia, and it may represent an underestimated biological problem with potential clinical consequences in sub-Saharan Africa.
MeSH term(s)	Humans ; Malaria, Vivax ; Antigens, Protozoan ; Protozoan Proteins/metabolism ; Plasmodium vivax/metabolism ; Erythrocytes ; Duffy Blood-Group System/genetics ; Duffy Blood-Group System/metabolism
Chemical Substances	Antigens, Protozoan ; Protozoan Proteins ; Duffy Blood-Group System
Language	English
Publishing date	2023-12-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	2278004-X
ISSN	1934-6069 ; 1931-3128
ISSN (online)	1934-6069
ISSN	1931-3128
DOI	10.1016/j.chom.2023.11.007
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Article ; Online: Identification of factors associated with residual malaria transmission using school-based serological surveys in settings pursuing elimination.

Rakotondramanga, Jean Marius / Vigan-Womas, Inès / Steinhardt, Laura C / Harimanana, Aina / Ravaoarisoa, Elisabeth / Rasoloharimanana, Tsikiniaina L / Razanatsiorimalala, Seheno / Wesolowski, Amy / Randrianarivelojosia, Milijaona / Roche, Benjamin / Garchitorena, Andres

Malaria journal

2022 Volume 21, Issue 1, Page(s) 242

Abstract: Background: Targeted research on residual malaria transmission is important to improve strategies in settings pursuing elimination, where transmission reductions prove challenging. This study aimed to detect and characterize spatial heterogeneity and ... ...

Abstract	Background: Targeted research on residual malaria transmission is important to improve strategies in settings pursuing elimination, where transmission reductions prove challenging. This study aimed to detect and characterize spatial heterogeneity and factors associated with Plasmodium falciparum infections and exposure, P. falciparum apical membrane antigen 1 (PfAMA1) antibody (Ab) response, in the Central Highlands of Madagascar (CHL). Methods: From May to July 2014, a cross-sectional school-based survey was carried out in 182 fokontany (villages) within 7 health districts of the CHL. Rapid diagnostic tests (RDTs) and a bead-based immunoassay including PfAMA1 antigen biomarker were used to estimate malaria prevalence and seroprevalence, respectively. Local Moran's I index was used to detect spatial "hotspots". Remotely sensed environmental data-temperature, vegetation indices, land covers, and elevation-were used in multivariable mixed-effects logistic regression models to characterize factors associated with malaria infection and cumulative exposure. Results: Among 6,293 school-children ages 2-14 years surveyed, RDT prevalence was low at 0.8% (95% CI 0.6-1.1%), while PfAMA1 Ab seroprevalence was 7.0% (95% CI 6.4-7.7%). Hotspots of PfAMA1 Ab seroprevalence were observed in two districts (Ankazobe and Mandoto). Seroprevalence increased for children living > 5 km from a health centre (adjusted odds ratio (OR) = 1.6, 95% CI 1.2-2.2), and for those experiencing a fever episode in the previous 2 weeks (OR 1.7, 95% CI 1.2-2.4), but decreased at higher elevation (for each 100-m increase, OR = 0.7, 95% CI 0.6-0.8). A clear age pattern was observed whereby children 9-10 years old had an OR of 1.8 (95% CI 1.2-2.4), children 11-12 years an OR of 3.7 (95% CI 2.8-5.0), and children 13-14 years an OR of 5.7 (95% CI 4.0-8.0) for seropositivity, compared with younger children (2-8 years). Conclusion: The use of serology in this study provided a better understanding of malaria hotspots and associated factors, revealing a pattern of higher transmission linked to geographical barriers in health care access. The integration of antibody-assays into existing surveillance activities could improve exposure assessment, and may help to monitor the effectiveness of malaria control efforts and adapt elimination interventions.
MeSH term(s)	Adolescent ; Child ; Child, Preschool ; Cross-Sectional Studies ; Humans ; Malaria/epidemiology ; Malaria, Falciparum/epidemiology ; Plasmodium falciparum ; Prevalence ; Seroepidemiologic Studies
Language	English
Publishing date	2022-08-21
Publishing country	England
Document type	Journal Article
ZDB-ID	2091229-8
ISSN	1475-2875 ; 1475-2875
ISSN (online)	1475-2875
ISSN	1475-2875
DOI	10.1186/s12936-022-04260-0
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Article ; Online: Changes in Systemic Regulatory T Cells, Effector T Cells, and Monocyte Populations Associated With Early-Life Stunting.

Andriamanantena, Zo / Randrianarisaona, Fanirisoa / Rakotondrainipiana, Maheninasy / Andriantsalama, Prisca / Randriamparany, Ravaka / Randremanana, Rindra / Randrianirina, Frédérique / Novault, Sophie / Duffy, Darragh / Huetz, François / Hasan, Milena / Schoenhals, Matthieu / Sansonetti, Philippe J / Vonaesch, Pascale / Vigan-Womas, Inès

Frontiers in immunology

2022 Volume 13, Page(s) 864084

Abstract: Stunting and environmental enteric dysfunction (EED) may be responsible for altered gut and systemic immune responses. However, their impact on circulating immune cell populations remains poorly characterized during early life. A detailed flow cytometry ... ...

Abstract	Stunting and environmental enteric dysfunction (EED) may be responsible for altered gut and systemic immune responses. However, their impact on circulating immune cell populations remains poorly characterized during early life. A detailed flow cytometry analysis of major systemic immune cell populations in 53 stunted and 52 non-stunted (2 to 5 years old) children living in Antananarivo (Madagascar) was performed. Compared to age-matched non-stunted controls, stunted children aged 2-3 years old had a significantly lower relative proportion of classical monocytes. No significant associations were found between stunting and the percentages of effector T helper cell populations (Th1, Th2, Th17, Th1Th17, and cTfh). However, we found that HLA-DR expression (MFI) on all memory CD4
MeSH term(s)	Child ; Child, Preschool ; Growth Disorders ; Humans ; Monocytes ; T-Lymphocyte Subsets ; T-Lymphocytes, Regulatory ; Th17 Cells
Language	English
Publishing date	2022-06-02
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2022.864084
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Article: Differential contribution of Anopheles coustani and Anopheles arabiensis to the transmission of Plasmodium falciparum and Plasmodium vivax in two neighbouring villages of Madagascar

Goupeyou-Youmsi, Jessy / Rakotondranaivo, Tsiriniaina / Puchot, Nicolas / Peterson, Ingrid / Girod, Romain / Vigan-Womas, Inès / Paul, Richard / Ndiath, Mamadou Ousmane / Bourgouin, Catherine

Parasites & vectors. 2020 Dec., v. 13, no. 1

2020

Abstract: BACKGROUND: Malaria is still a heavy public health concern in Madagascar. Few studies combining parasitology and entomology have been conducted despite the need for accurate information to design effective vector control measures. In a Malagasy region of ...

Abstract	BACKGROUND: Malaria is still a heavy public health concern in Madagascar. Few studies combining parasitology and entomology have been conducted despite the need for accurate information to design effective vector control measures. In a Malagasy region of moderate to intense transmission of both Plasmodium falciparum and P. vivax, parasitology and entomology have been combined to survey malaria transmission in two nearby villages. METHODS: Community-based surveys were conducted in the villages of Ambohitromby and Miarinarivo at three time points (T1, T2 and T3) during a single malaria transmission season. Human malaria prevalence was determined by rapid diagnostic tests (RDTs), microscopy and real-time PCR. Mosquitoes were collected by human landing catches and pyrethrum spray catches and the presence of Plasmodium sporozoites was assessed by TaqMan assay. RESULTS: Malaria prevalence was not significantly different between villages, with an average of 8.0% by RDT, 4.8% by microscopy and 11.9% by PCR. This was mainly due to P. falciparum and to a lesser extent to P. vivax. However, there was a significantly higher prevalence rate as determined by PCR at T2 ([Formula: see text] = 7.46, P = 0.025). Likewise, mosquitoes were significantly more abundant at T2 ([Formula: see text] = 64.8, P < 0.001), especially in Ambohitromby. At T1 and T3 mosquito abundance was higher in Miarinarivo than in Ambohitromby ([Formula: see text] = 14.92, P < 0.001). Of 1550 Anopheles mosquitoes tested, 28 (1.8%) were found carrying Plasmodium sporozoites. The entomological inoculation rate revealed that Anopheles coustani played a major contribution in malaria transmission in Miarinarivo, being responsible of 61.2 infective bites per human (ib/h) during the whole six months of the survey, whereas, it was An. arabiensis, with 36 ib/h, that played that role in Ambohitromby. CONCLUSIONS: Despite a similar malaria prevalence in two nearby villages, the entomological survey showed a different contribution of An. coustani and An. arabiensis to malaria transmission in each village. Importantly, the suspected secondary malaria vector An. coustani, was found playing the major role in malaria transmission in one village. This highlights the importance of combining parasitology and entomology surveys for better targeting local malaria vectors. Such study should contribute to the malaria pre-elimination goal established under the 2018–2022 National Malaria Strategic Plan.
Keywords	Anopheles arabiensis ; Anopheles coustani ; Plasmodium falciparum ; Plasmodium vivax ; entomology ; humans ; insect surveys ; malaria ; microscopy ; mosquito vectors ; parasitology ; public health ; quantitative polymerase chain reaction ; sporozoites ; vector control ; villages ; Madagascar
Language	English
Dates of publication	2020-12
Size	p. 430.
Publishing place	BioMed Central
Document type	Article
Note	NAL-light
ZDB-ID	2409480-8
ISSN	1756-3305
ISSN	1756-3305
DOI	10.1186/s13071-020-04282-0
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Prevalence and factors associated with human Taenia solium taeniosis and cysticercosis in twelve remote villages of Ranomafana rainforest, Madagascar.

Rahantamalala, Anjanirina / Rakotoarison, Rado Lalaina / Rakotomalala, Emma / Rakotondrazaka, Mahenintsoa / Kiernan, Jaydon / Castle, Paul M / Hakami, Lee / Choi, Koeun / Rafalimanantsoa, Armand Solofoniaina / Harimanana, Aina / Wright, Patricia / Grandjean Lapierre, Simon / Schoenhals, Matthieu / Small, Peter M / Marcos, Luis A / Vigan-Womas, Inès

PLoS neglected tropical diseases

2022 Volume 16, Issue 4, Page(s) e0010265

Abstract: Background: Infections with the tapeworm Taenia solium (taeniosis and cysticercosis) are Neglected Tropical Diseases (NTD) highly endemic in Madagascar. These infections are however underdiagnosed, underreported and their burden at the community level ... ...

Abstract	Background: Infections with the tapeworm Taenia solium (taeniosis and cysticercosis) are Neglected Tropical Diseases (NTD) highly endemic in Madagascar. These infections are however underdiagnosed, underreported and their burden at the community level remains unknown especially in rural remote settings. This study aims at assessing the prevalence of T. solium infections and associated risk factors in twelve remote villages surrounding Ranomafana National Park (RNP), Ifanadiana District, Madagascar. Methodology: A community based cross-sectional survey was conducted in June 2016. Stool and serum samples were collected from participants. Tapeworm carriers were identified by stool examination. Taenia species and T. solium genotypes were characterised by PCR and sequencing of the mitochondrial cytochrome c oxidase subunit 1 (cox1) gene. Detection of specific anti-cysticercal antibodies (IgG) or circulating cysticercal antigens was performed by ELISA or EITB/Western blot assays. Principal findings: Of the 459 participants with paired stool and blood samples included ten participants from seven distinct villages harbored Taenia spp. eggs in their stools samples DNA sequencing of the cox1 gene revealed a majority of T. solium Asian genotype (9/10) carriage. The overall seroprevalences of anti-cysticercal IgGs detected by ELISA and EITB were quite similar (27.5% and 29.8% respectively). A prevalence rate of 12.4% of circulating cysticercal antigens was observed reflecting cysticercosis with viable cysts. Open defecation (Odds Ratio, OR = 1.5, 95% CI: 1.0-2.3) and promiscuity with households of more than 4 people (OR = 1.9, 95% CI: 1.1-3.1) seem to be the main risk factors associated with anticysticercal antibodies detection. Being over 15 years of age would be a risk factor associated with an active cysticercosis (OR = 1.6, 95% CI: 1.0-2.7). Females (OR = 0.5, 95% CI: 0.3-0.9) and use of river as house water source (OR = 0.3, 95% CI: 0.1-1.5) were less likely to have cysticercosis with viable cysts. Conclusions/significance: This study indicates a high exposure of the investigated population to T. solium infections with a high prevalence of cysticercosis with viable cysts. These data can be useful to strengthen public health interventions in these remote settings.
MeSH term(s)	Animals ; Cross-Sectional Studies ; Cysticercosis/diagnosis ; Cysticercosis/epidemiology ; Cysticercus ; Cysts ; Female ; Humans ; Madagascar/epidemiology ; Neglected Diseases ; Prevalence ; Rainforest ; Swine ; Swine Diseases/epidemiology ; Taenia solium/genetics ; Taeniasis/epidemiology
Language	English
Publishing date	2022-04-11
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2429704-5
ISSN	1935-2735 ; 1935-2735
ISSN (online)	1935-2735
ISSN	1935-2735
DOI	10.1371/journal.pntd.0010265
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Article ; Online: High prevalence of intestinal parasite infestations among stunted and control children aged 2 to 5 years old in two neighborhoods of Antananarivo, Madagascar.

Habib, Azimdine / Andrianonimiadana, Lova / Rakotondrainipiana, Maheninasy / Andriantsalama, Prisca / Randriamparany, Ravaka / Randremanana, Rindra Vatosoa / Rakotoarison, Rado / Vigan-Womas, Inès / Rafalimanantsoa, Armand / Vonaesch, Pascale / Sansonetti, Philippe J / Collard, Jean-Marc

PLoS neglected tropical diseases

2021 Volume 15, Issue 4, Page(s) e0009333

Abstract: Background: This study aimed to compare the prevalence of intestinal parasite infestations (IPIs) in stunted children, compared to control children, in Ankasina and Andranomanalina Isotry (two disadvantaged neighborhoods of Antananarivo, Madagascar), to ...

Abstract	Background: This study aimed to compare the prevalence of intestinal parasite infestations (IPIs) in stunted children, compared to control children, in Ankasina and Andranomanalina Isotry (two disadvantaged neighborhoods of Antananarivo, Madagascar), to characterize associated risk factors and to compare IPI detection by real-time PCR and standard microscopy techniques. Methodology/principal findings: Fecal samples were collected from a total of 410 children (171 stunted and 239 control) aged 2-5 years. A single stool sample per subject was examined by simple merthiolate-iodine-formaldehyde (MIF), Kato-Katz smear and real-time PCR techniques. A total of 96.3% of the children were infested with at least one intestinal parasite. The most prevalent parasites were Giardia intestinalis (79.5%), Ascaris lumbricoides (68.3%) and Trichuris trichiura (68.0%). For all parasites studied, real-time PCR showed higher detection rates compared to microscopy (G. intestinalis [77.6% (n = 318) versus 20.9% (n = 86)], Entamoeba histolytica [15.8% (n = 65) versus 1.9% (n = 8)] and A. lumbricoides [64.1% (n = 263) versus 50.7% (n = 208)]). Among the different variables assessed in the study, age of 4 to 5 years (AOR = 4.61; 95% CI, (1.35-15.77)) and primary and secondary educational level of the mother (AOR = 12.59; 95% CI, (2.76-57.47); AOR = 9.17; 95% CI, (2.12-39.71), respectively) were significantly associated with IPIs. Children drinking untreated water was associated with infestation with G. intestinalis (AOR = 1.85; 95% CI, (1.1-3.09)) and E. histolytica (AOR = 1.9; 95% CI, (1.07-3.38)). E. histolytica was also associated with moderately stunted children (AOR = 0.37; 95% CI, 0.2-0.71). Similarly, children aged between 4 and 5 years (AOR = 3.2; 95% CI (2.04-5.01)) and living on noncemented soil types (AOR = 1.85; 95% CI, (1.18-2.09)) were associated with T. trichiura infestation. Conclusions/significance: The prevalence of IPIs is substantial in the studied areas in both stunted and control children, despite the large-scale drug administration of antiparasitic drugs in the country. This high prevalence of IPIs warrants further investigation. Improved health education, environmental sanitation and quality of water sources should be provided.
Language	English
Publishing date	2021-04-20
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2429704-5
ISSN	1935-2735 ; 1935-2727
ISSN (online)	1935-2735
ISSN	1935-2727
DOI	10.1371/journal.pntd.0009333
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