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Community data on the prevalence of helminth infections is important for guiding health policy, but expensive to collect. As a result most surveys focus on school-aged children, frequently using schools as a sentinel population. Since there already exists a vast amount of data on infection levels in school-aged children, but limited community-based data, we undertook a literature search on age-stratified infection data for intestinal nematode infections and schistosomiasis in Africa, to investigate whether estimates of the prevalence of infection in school-aged children could provide an index for determining community prevalence. The observed data on prevalence of infection in infants, school-aged children and adults were fitted using linear and logistic regression models which take into account variation in sample prevalences. Despite the wide variation in study sites, the observed relationship between community prevalence and school-aged prevalence was remarkably consistent for each parasite species. The prevalence of infection in school-aged children alone was shown to be higher than the predicted prevalence in the community, but the degree of overestimation was dependent on the parasite species and the level of infection. The results suggest that the prevalence of infection in school-aged children could provide a cost-effective predictive tool which can be used at a district/national level to identify target areas for control and to evaluate the numbers at risk of infection.

Original publication

DOI

10.1017/s0031182098003862

Type

Journal article

Journal

Parasitology

Publication Date

03/1999

Volume

118 ( Pt 3)

Pages

257 - 268

Addresses

Wellcome Trust Centre for the Epidemiology of Infectious Disease, Department of Zoology, University of Oxford. helen.guyatt@zoology.oxford.-ac.uk

Keywords

Animals, Humans, Nematode Infections, Schistosomiasis, Sentinel Surveillance, Prevalence, Models, Statistical, Linear Models, Logistic Models, Predictive Value of Tests, Age Distribution, Adolescent, Adult, Child, Child, Preschool, Africa