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Improving Water Quality in Bangladesh Reduces Hookworm Prevalence by 30%

Published on Fri Jan 11 2019 by Dustin Van Tate TestaLots of Water | Susanne Nilsson on Flickr Lots of Water | Susanne Nilsson on Flickr

A new study conducted in rural Bangladesh reveals promise for further reducing soil-transmitted helminth (STH) infections among young children, a problem currently afflicting more than 1.5 billion people worldwide. Despite widespread use of mass drug administration (MDA) to combat these infections, drug resistance and rapid reinfection rates pose significant challenges to controlling STH. Researchers from several institutions, including North Carolina State University and the University of California, Berkeley, tested the effectiveness of interventions beyond MDA, examining whether improving water quality, sanitation, handwashing, and nutrition could lower STH infection rates.

The cluster-randomized controlled trial, which followed households over 2.5 years, demonstrated a sustained reduction in hookworm infection from interventions that treated drinking water and improved sanitation practices. Hookworm, which was relatively rare among the study population, saw a roughly 30% drop in prevalence when interventions were employed. Interestingly, the study did not find similar reductions for other types of STH infections, such as those from Ascaris lumbricoides (roundworm) and Trichuris trichiura (whipworm), which were more prevalent.

One important aspect of the study’s findings highlighted that treated drinking water may serve as an overlooked route of transmission for hookworm, suggesting potential for water treatment interventions to augment the impact of MDA programs. By focusing efforts on waterborne transmission, particularly for hookworm, there's a prospect for making greater strides toward eradicating STH infections.

However, the study was not without its limitations, including the difficulty of detecting low-intensity infections with the diagnostic methods used. Furthermore, the results might be specific to the setting of the study, which had ongoing MDA and low-intensity infections overall. The findings imply that while improvements in handwashing and nutrition did not significantly affect STH prevalence, interventions focusing on water and sanitation may play a crucial role in breaking the cycle of infection, especially in settings where MDA alone is not sufficient.

Overall, these outcomes offer valuable insights into potential strategies to supplement existing STH control programs. As the global health community aims to move toward the elimination of STH, integrating water treatment and sanitation improvements with pharmaceutical interventions may be a key step forward.


Written by Ercumen, A., Benjamin-Chung, J., Arnold, B. F., Lin, A., Hubbard, A. E., Stewart, C., Rahman, Z., Parvez, S. M., Unicomb, L., Rahman, M., Haque, R., Colford, J. M., Luby, S. P.
Tags: Biology | Biology:Clinical Trials

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