Nigeria remains the most endemic country in sub-Saharan Africa (SSA) for soil-transmitted helminthiases (STH). In line with ongoing monitoring plans, we present findings from a recent analysis of STH epidemiological data in Borgu, one of the non-endemic implementation units for STH in the northcentral region of Nigeria. An overall prevalence of 8.8% was recorded for STH infection, which corresponds to a 51.9% decline from the 18.3% reported in 2013. All the infected participants (36 out of 410) had a low intensity of infection. However, more than two-thirds (69%) of the children do not have access to latrine facilities, and 45% of them walk barefoot. Prevalence was significantly associated with community, age, and parental occupation. About 21–25% reduced odds were reported in some of the study communities, and children whose parents were traders had 20 times lower odds of infection compared to those whose parents were farmers. The ongoing preventive chemotherapy program for lymphatic filariasis in the area could be responsible for the huge reduction in prevalence and intensity estimates for STH. It is therefore important to invest in monitoring transmission dynamics in other non-endemic areas to arrest emerging threats through the provision of complementary interventions including WASH facilities and other health educational tools.

Background: Schistosomiasis (SCH) and soil transmitted helminthiasis (STH) have been targeted for elimination as a public health problem (EPHP) within the World Health Organization (WHO)’s Roadmap for Neglected Tropical Diseases (NTDs) 2021–2030. One of the global strategies for the control and elimination of these diseases is the mass administration of praziquantel and albendazole/mebendazole without prior individual diagnosis. To measure the progress towards the 2030 target, we conducted an assessment to determine the impact of the 3–5 rounds of annual mass drug administration among school age children in Ekiti State. Such scientific insights into the impact of these treatments will facilitate improved planning and targeting of resources towards reaching the last mile. Methodology: This assessment was conducted in 16 local government areas (LGAs) of Ekiti State between October and November 2023. Samples were collected from pupils in 166 primary and junior secondary schools across 166 wards of the State. Urine and stool samples were collected from 7670 pupils of ages 5 to 14 years, following standard laboratory procedures. Urine membrane filtration techniques were used for urine preparation while the Kato–Katz technique was used for stool preparation. A novel AiDx digital microscope was used to examine the presence of any ova in the prepared specimen. Parasite ova in urine were reported as the number of ova/10 mL of urine, and were categorized as light infection (˂50 ova/10 mL of urine) or heavy infection (>50 ova/10 mL of urine) while ova of parasites in stool samples were reported as eggs per gram of stool (EPG) and categorized into light, moderate and heavy infection. Results: Overall, 0.76% (0.56–0.95) at 95% CI of the 7670 respondents were infected with Schistosomia haematobium. No Schistosoma mansoni infection was recorded in the study. Similarly, 3.9% (3.43–4.29) at 95% CI were infected with STHs. The overall prevalence of schistosomiasis had significantly reduced from 8.2% in 2008 to 0.8%, while the overall prevalence of STHs significantly reduced from 30.9% to 3.9% with Ascaris lumbricoides being the dominant species of STH. In the 16 LGAs assessed, Ekiti West had the highest S. haematobium prevalence of 4.26%. Ise/Orun and Oye ranked second and third with a prevalence of 3.48% and 2.40% respectively, while all other LGAs had <1% prevalence. The prevalence of STHs was highest in Ekiti-West with a prevalence of 10.45% while Emure and Ikole Local Governments had the lowest prevalence of 0.31% and 0.38%, respectively. There was no significant difference in the prevalence of schistosomiasis between male (0.76%) and female (0.75%) as p ≥ 0.05. Similarly, the difference in prevalence for STH among males (3.95%) was not significantly different from their female counterparts (3.77%), p ≥ 0.05. Conclusions: Based on the WHO guidelines, this study demonstrated that only three LGAs require continued MDA every 2/3 years, seven require only surveillance while six are now non-endemic for schistosomiasis. Similarly, two of the LGAs require one round of MDA yearly, eight LGAs need one round of MDA every two to three years and six LGAs are now below the treatment threshold and no longer require treatment for STH.

As Nigeria advances toward the elimination of soil-transmitted helminthiasis (STH), updated endemicity maps are essential for guiding programmatic decisions. A cross-sectional study was conducted to update the STH endemicity maps in ten local government areas (LGAs) of Ondo State from July to August 2024. LGAs were stratified into three categories (C1–C3) based on the history of preventive chemotherapy (PC), with C1 being endemic LGAs with ≥5 effective rounds of PC, C2 being endemic LGAs with <5 effective rounds of PC, and C3 being low-endemicity (STH prevalence <20%; PC not required). A total of 4507 school-aged children (5–14 years) from 151 systematically selected communities (15 per LGA) provided fresh stool samples to assess the prevalence and intensity of STH. Stool samples were examined using the Kato-Katz technique. Prevalence of STH was aggregated at the LGA level and compared with World Health Organization thresholds. In the first category (C1), the baseline prevalence was reduced significantly by 60–96%, with specific prevalence in Akoko Southwest (from 28.2% to 0.4%, Risk Ratio (RR): 0.01), Akure North (from 39% to 1.5%, RR = 0.04), Ifedore (from 25% to 2.5%, RR = 0.10), and Ondo East (from 45.2% to 8.2%, RR = 0.18). In the second category (C2), the baseline was reduced significantly by 66–100%, with Akure South (from 29% to 1.2%, RR = 0.04), Ose (from 20% to 2.2%, RR = 0.11), Owo (~100% reduction), and Odigbo (38% to 12.8%, RR = 0.34). In the C3 LGAs, infection was significantly below the baseline threshold, with Akoko Northwest (5.2% to 0.9%, RR = 0.17) and Idanre (from 14.2% to 1.8%, RR = 0.13). Overall, significant reductions in STH prevalence were observed across the surveyed LGAs, with risk ratios ranging from 0.04 to 0.40. These findings updated the endemicity map for the ten LGAs in Ondo State, demonstrating significant progress toward STH elimination following PC implementation.

: Efforts to eliminate schistosomiasis in Africa have advanced, with most countries evaluating the impact of preventive chemotherapy (PC) on disease burden. WHO has recommended eight distinct methodologies for such assessment. We, therefore, investigated the sensitivity of three prominent methodologies—sentinel, cluster, and practical, each varying in site selection, sampling approach, and data interpretation. We conducted a cross-sectional study among 2,093 children across 45 schools in Ese-Odo, Ile-Oluiji, and Irele local government areas (LGAs) of Ondo, Nigeria. Fresh stool and urine samples were processed using Kato–Katz and urine filtration techniques to estimate prevalence, which was compared with 2014 baseline estimates. Findings showed significant prevalence reductions in Ese-Odo from 1.3% (95% CI: 0.5–3.3) at baseline to 0.1% (95% CI: 0.01–0.95) at impact (d = −92.3%, P = 0.03) and in Ile-Oluiji from 58.0% (95% CI: 53.9–62.1) to 1.8% (95% CI: 0.9–3.3; d = −97%, P = 0.00). However, it increased from 3.0% (95% CI: 1.6–5.6) to 5.3% (95% CI: 3.8–7.3) in Irele (d = 66%, P = 0.13). Higher prevalence estimates were observed with the practical method compared with cluster and sentinel across the three LGAs: 0.3% versus 0.1% versus 0.0% in Ese-Odo, 5.8% versus 5.3% versus 5.4% in Irele, and 2.2% versus 1.8% versus 1.5% in Ile-Oluiji (all P >0.05). Sentinel and cluster methodologies suggest stopping PC, whereas the practical method suggests continued PC in Irele. Our findings demonstrate that practical assessment is a sensitive method for refining PC decisions.

As Nigeria advances toward the elimination of soil-transmitted helminthiasis (STH), updated endemicity maps are essential for guiding programmatic decisions. Here, we conducted a cross-sectional study from July to August 2024 in ten local government areas (LGAs) of Ondo State to update the STH endemicity maps. LGAs were stratified into three categories (C1-C3) based on the history of preventive chemotherapy (PC), with C1 being endemic LGAs with ≥ 5 effective rounds of PC, C2 being endemic LGAs with < 5 effective rounds of PC, and C3 being low-endemicity (STH prevalence < 20%; PC not required). A total of 4507 school-aged children (5–14 years) from 151 systematically selected communities (15 per LGA) provided fresh stool samples to assess the prevalence and intensity of STH. Stool samples were examined using the Kato-Katz technique. Prevalence of STH was aggregated at the LGA level and compared with World Health Organization thresholds. In the first category (C1), the baseline prevalence was reduced significantly by 60-96%, with specific prevalence in Akoko Southwest (from 28.2% to 0.4%, Risk Ratio (RR): 0.01), Akure North (from 39% to 1.5%, RR=0.04), Ifedore (from 25% to 2.5%, RR= 0.10), and Ondo East(from 45.2% to 8.2%, RR= 0.18). In the second category (C2), the baseline was reduced significantly by 66-100%, with Akure South (from 29% to 1.2%, RR= 0.04), Ose (from 20% to 2.2%, RR= 0.11), Owo (~100% reduction), and Odigbo (38% to 12.8%, RR= 0.34). In the C3 LGAs, infection was significantly below the baseline threshold, with Akoko Northwest (5.2% to 0.9%, RR=0.17) and Idanre (from 14.2% to 1.8%, RR=0.13). Overall, significant reductions in STH prevalence were observed across the surveyed LGAs, with risk ratios ranging from 0.04 to 0.40. These findings updated the endemicity map for the ten LGAs in Ondo State, demonstrating significant progress toward STH elimination following PC implementation.

Background: Granular assessment of Schistosomiasis (SCH) and soil-transmitted helminthiasis (STHs) in a population with instituted treatment programs is a critical step in understanding the progress of control programs towards the 2030 elimination targets. Such scientific insight into the impact of recurrent rounds of mass treatment with Praziquantel and Albendazole/Mebendazole should facilitate improved planning and targeting of resources. Methodology: This schistosomiasis and STHs granular assessment was conducted in 16 Local Government Areas (LGAs) of Ekiti State between October and November 2023. Samples were collected from pupils in166 primary and junior secondary schools across 166 wards/communities. Urine and stool samples were collected from 7670 pupils between 5 and 14 years, comprising 3823 (49.8%) males and 3847 (50.1%) females. When aggregated at individual LGA, the highest number of participants (658 children) was recorded in Ado Ekiti LGA. Emure recorded the lowest number of participants with 320 children across 9 out of 10 wards in the LGA. The result of this granular assessment was compared to the 2008 and 2015 baseline prevalence of each LGA to assess the level of reduction in both prevalence and intensity. Results: Overall, 58 (0.76%) out of 7670 pupils were infected with Schistosomia haematobium. No Schistosoma mansoni infection was recorded in any of the 7670 analyzed samples. Two hundred and ninety-six (3.86%) of the examined samples were infected with STHs. In the 16 LGAs assessed, Ekiti West had the highest S. haematobium prevalence of 4.26%. Ise/Orun and Oye ranked 2nd and 3rd with a prevalence of 3.48% & 2.40% respectively. There were no reported infection of S. haematobium in Efon, Ekiti-East, Ekiti South-west, Ido/Osi & Moba, LGAs while a further 7 LGAs had <1% prevalence. The prevalence of STHs was highest in Ekiti-West with a prevalence of 10.45%. Gbonyin & Ise/Orun had the prevalence of 9.62% & 8.9% respectively, making them 2nd and 3rd in ranking accordingly. Emure, Ikole and Irepodun Local Governments had the lowest prevalence of 0.31%, 0.38% & 1.01% respectively. Conclusion: There was a sharp decline in the prevalence of S. haematobium & STHs in the State across the 16 LGAs as compared to the baseline prevalence obtained from the Federal Ministry of Health NTD program. Our assessment demonstrates that only 3 LGAs require continued MDA every 2/3 years based on the WHO guidelines, while 6 are now non-endemic and 7 require only surveillance. The prevalence of STHs has significantly reduced across the 16 LGAs. Comparative analysis of the computed and baseline prevalence shows that 6 LGAs are not endemic according to WHO guidelines. Two of the assessed LGAs require one round of MDA yearly and 8 LGAs need one round of MDA every two to three years.