02608nas a2200289   4500000000100000008004100001653001200042653004100054653003600095653001100131653002500142100001800167700001200185700001200197700001400209700001100223700001600234700001600250700002100266700001600287700001400303700001200317245012600329856004200455490000600497520181500503       2019                            d10aMapping10aSoil-transmitted helminth infections10aSoil-transmitted helminth (STH)10aRwanda10aSpatial epidemiology1 aRuberanziza E1 aOwada K1 aClark N1 aUmulisa I1 aOrtu G1 aLancaster W1 aMunyaneza T1 aMbituyumuremyi A1 aBayisenge U1 aFenwick A1 aães RJ00aMapping Soil-Transmitted Helminth Parasite Infection in Rwanda: Estimating Endemicity and Identifying At-Risk Populations  uhttps://www.mdpi.com/2414-6366/4/2/930 v43 a<p>Soil-transmitted helminth (STH) infections are globally distributed intestinal parasite infections caused by&nbsp;<em>Ascaris lumbricoides</em>,&nbsp;<em>Trichuris trichiura</em>, and hookworms (<em>Ancylostoma duodenale</em>&nbsp;and&nbsp;<em>Necator americanus</em>). STH infection constitutes a major public health threat, with heavy burdens observed in many of the world’s tropical and subtropical regions. Mass drug administration and sanitation improvements can drastically reduce STH prevalence and associated morbidity. However, identifying targeted areas in need of treatment is hampered by a lack of knowledge on geographical and population-level risk factors. In this study, we applied Bayesian geostatistical modelling to data from a national school-based STH infection survey in Rwanda to (1) identify ecological and population-level risk factors and (2) provide comprehensive precision maps of infection burdens. Our results indicated that STH infections were heterogeneously distributed across the country and showed signatures of spatial clustering, though the magnitude of clustering varied among parasites. The highest rates of endemic clustering were attributed to&nbsp;<em>A. lumbricoides</em>&nbsp;infection. Concordant infection patterns among the three parasite groups highlighted populations currently most at-risk of morbidity. Population-dense areas in the Western and North-Western regions of Rwanda represent areas that have continued to exhibit high STH burden across two surveys and are likely in need of targeted interventions. Our maps support the need for an updated evaluation of STH endemicity in western Rwanda to evaluate progress in MDA efforts and identify communities that need further local interventions to further reduce morbidity caused by STH infections.</p>