{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T14:51:23Z","timestamp":1758120683876,"version":"3.37.3"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T00:00:00Z","timestamp":1621382400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T00:00:00Z","timestamp":1621382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior"],"award-info":[{"award-number":["Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Public Health"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Most of the studies conducted in Brazil assessing the relationship between water, sanitation and hygiene (WASH) and Soil-transmitted helminth (STH)\u00a0infections, have focused on cases, reflecting the reality of small areas and not of a countrywide situation. In order to fill this gap, the current paper presents an epidemiological study exploring the association between water and sanitation and STHs prevalence in students from 7 to 17 years old, in all 27 Brazilian Federation Units.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Three ecological studies were carried out considering the prevalence of ascariasis, trichuriasis, and hookworm as outcome variables. The sample consisted of 197,567 students aged 7\u201317 years old living in 521 Brazilian municipalities. Data were retrieved from the National Survey on the Prevalence of Schistosomiasis mansoni and Soil-transmitted helminth infections (2011\u20132015). The Generalized Linear Model with the negative binomial distribution was used to evaluate the statistical association between outcomes and explanatory variables. Univariate and Multivariate analyses were conducted with 25 and 5\u2009% significance levels, respectively. Data were aggregated considering municipalities as the geographical unit for analysis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Protective association was found between access to filtered water and adequate sanitation in schools with ascariasis (RR 0.989, CI 95\u2009% 0.983\u20130.996; RR 0.988, CI 95\u2009% 0.977\u20130.998), access to filtered water in schools with trichuriasis (RR 0.986, CI 95\u2009% 0.979\u20130.993) and adequate sanitation at home with hookworm ((RR 0.989, CI 95\u2009% 0.982\u20130.996). The percentage of population served with <jats:italic>Bolsa Fam\u00edlia<\/jats:italic> Program, used as a proxy for poverty, was the only significant variable common to all models.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Our findings support that WASH, both in schools and homes, are essential to schoolchildren health with regard to STHs. However, sanitary interventions will not be fully effective in preventing STH\u00a0infections without promoting access to quality public services, particularly for people living in poverty, the most vulnerable group.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13690-021-00602-7","type":"journal-article","created":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T08:02:49Z","timestamp":1621411369000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Association between water and sanitation and soil-transmitted helminthiases: Analysis of the Brazilian National Survey of Prevalence (2011\u20132015)"],"prefix":"10.1186","volume":"79","author":[{"given":"Kasandra Isabella Helouise","family":"Mingoti Poague","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sueli Aparecida","family":"Mingoti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L\u00e9o","family":"Heller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,5,19]]},"reference":[{"key":"602_CR1","unstructured":"World Health Organization (WHO). Paediatric chewable medicine promises improved treatment against intestinal worms. 2018. https:\/\/www.who.int\/neglected_diseases\/news\/Paediatric-chewable-medicine-promises-improved-treatment_against\/en\/. Accessed 23 Aug 2018."},{"key":"602_CR2","first-page":"883","volume-title":"Parasitologia: parasitos e doen\u00e7as parasit\u00e1rias do homem nos tr\u00f3picos ocidentais. 4th ed (Reprint)","author":"L Rey","year":"2014","unstructured":"Rey L. Parasitologia: parasitos e doen\u00e7as parasit\u00e1rias do homem nos tr\u00f3picos ocidentais. 4th ed (Reprint). Rio de Janeiro: Guanabara koogan; 2014. p. 883."},{"key":"602_CR3","unstructured":"World Health Organization (WHO). Neglected tropical diseases - PTC databank. 2020. https:\/\/www.who.int\/neglected_diseases\/preventive_chemotherapy\/sth\/en\/. Acccesed 04 Aug 2020."},{"issue":"1","key":"602_CR4","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1590\/S0102-311X2010000100015","volume":"26","author":"EOL Fonseca","year":"2010","unstructured":"Fonseca EOL, Teixeira MG, Barreto ML, Carmo EH, Costa MDCN. Preval\u00eancia e fatores associados \u00e0s geo-helmint\u00edases em crian\u00e7as residentes em munic\u00edpios com baixo IDH no Norte e Nordeste brasileiros. Cad Saude Publica. 2010;26(1):143\u201352.","journal-title":"Cad Saude Publica."},{"issue":"8","key":"602_CR5","doi-asserted-by":"publisher","first-page":"3481","DOI":"10.1590\/S1413-81232011000900016","volume":"16","author":"S Visser","year":"2011","unstructured":"Visser S, Giatti LL, de Carvalho RAC, Guerreiro JCH. Estudo da associa\u00e7\u00e3o entre fatores socioambientais e preval\u00eancia de parasitose intestinal em \u00e1rea perif\u00e9rica da cidade de Manaus (AM, Brasil). Ci\u00eanc Sa\u00fade Colet. 2011;16(8):3481\u201392.","journal-title":"Ci\u00eanc Sa\u00fade Colet"},{"key":"602_CR6","unstructured":"Katz N. Inqu\u00e9rito Nacional de Preval\u00eancia da Esquitossomose Mansoni e Geo-helmintoses. Belo Horizonte, CPqRR; 2018. https:\/\/www.arca.fiocruz.br\/handle\/icict\/25662. Accessed 23 Aug 2018."},{"issue":"1","key":"602_CR7","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1186\/s40249-016-0168-z","volume":"5","author":"YT Chin","year":"2016","unstructured":"Chin YT, Lim YAL, Chong CW, Teh CSJ, Yap IKS, Lee SC, et al. Prevalence and risk factors of intestinal parasitism among two indigenous sub-ethnic groups in Peninsular Malaysia. Infect Dis Poverty. 2016;5(1):77.","journal-title":"Infect Dis Poverty"},{"issue":"3","key":"602_CR8","doi-asserted-by":"publisher","first-page":"e1001620","DOI":"10.1371\/journal.pmed.1001620","volume":"11","author":"EC Strunz","year":"2014","unstructured":"Strunz EC, Addiss DG, Stocks ME, Ogden S, Utzinger J, Freeman MC. Water, Sanitation, Hygiene, and Soil-Transmitted Helminth Infection: A Systematic Review and Meta-Analysis. PLoS Med. 2014;11(3):e1001620.","journal-title":"PLoS Med"},{"issue":"1","key":"602_CR9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13071-014-0608-1","volume":"8","author":"MC Freeman","year":"2015","unstructured":"Freeman MC, Chard AN, Nikolay B, Garn JV, Okoyo C, Kihara J, et al. Associations between school- and household-level water, sanitation and hygiene conditions and soil-transmitted helminth infection among Kenyan school children. Parasit Vectors. 2015;8(1):1\u201313.","journal-title":"Parasit Vectors."},{"key":"602_CR10","unstructured":"Minist\u00e9rio das Cidades. Plano Nacional de Saneamento B\u00e1sico - PLANSAB. Bras\u00edlia. 2013. https:\/\/www2.mma.gov.br\/port\/conama\/processos\/AECBF8E2\/Plansab_Versao_Conselhos_Nacionais_020520131.pdf. Accessed 27 Apr 2018."},{"key":"602_CR11","first-page":"107","volume-title":"Abastecimento de \u00e1gua para consumo humano","author":"M Lib\u00e2nio","year":"2016","unstructured":"Lib\u00e2nio M, Neto MLF, Prince AA, Sperling MV, Heller L. Consumo de \u00c1gua. In: Heller L, P\u00e1dua VL, editors. Abastecimento de \u00e1gua para consumo humano. 3rd ed. Belo Horizonte: Editora UFMG; 2016. p. 107\u201350.","edition":"3"},{"key":"602_CR12","doi-asserted-by":"publisher","first-page":"576","DOI":"10.1017\/CBO9780511973420","volume-title":"Negative Binomial Regression","author":"JM Hilbe","year":"2011","unstructured":"Hilbe JM. Negative Binomial Regression. 2nd ed. Cambridge: Cambridge University Press; 2011. p. 576.","edition":"2"},{"issue":"357","key":"602_CR13","first-page":"46","volume":"72","author":"RB Bendel","year":"1977","unstructured":"Bendel RB, Afifi AA. Comparison of Stopping Rules in Forward \u201cStepwise\u201d Regression. J Am Stat Assoc. 1977;72(357):46\u201353.","journal-title":"J Am Stat Assoc."},{"key":"602_CR14","first-page":"865","volume-title":"Veterinary Epidemiologic Research","author":"I Dohoo","year":"2009","unstructured":"Dohoo I, Martin W, Stryhn H. Veterinary Epidemiologic Research. 2nd ed. Charlottetown: VER Inc; 2009. p. 865.","edition":"2"},{"key":"602_CR15","volume-title":"Stata 14 Base Reference Manual","author":"StataCorp","year":"2015","unstructured":"StataCorp. Stata 14 Base Reference Manual. College Station: Stata Press; 2015."},{"key":"602_CR16","doi-asserted-by":"crossref","unstructured":"Karan A, Chapman GB, Galvani A. The influence of poverty and culture on the transmission of parasitic infections in rural Nicaraguan villages. J Parasitol Res. 2012:478292.","DOI":"10.1155\/2012\/478292"},{"issue":"1","key":"602_CR17","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1471-2458-13-304","volume":"13","author":"A Gelaw","year":"2013","unstructured":"Gelaw A, Anagaw B, Nigussie B, Silesh B, Yirga A, Alem M, et al. Prevalence of intestinal parasitic infections and risk factors among schoolchildren at the University of Gondar Community School, Northwest Ethiopia: A cross-sectional study. BMC Public Health. 2013;13(1):1.","journal-title":"BMC Public Health."},{"issue":"1","key":"602_CR18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12879-017-2466-x","volume":"17","author":"T Hailegebriel","year":"2017","unstructured":"Hailegebriel T. Prevalence of intestinal parasitic infections and associated risk factors among students at Dona Berber primary school, Bahir Dar, Ethiopia. BMC Infect Dis. 2017;17(1):1\u20138.","journal-title":"BMC Infect Dis."},{"key":"602_CR19","unstructured":"Estabelece as diretrizes e as bases para a educa\u00e7\u00e3o nacional. Pub. L. N\u00ba 9.394. Di\u00e1rio Oficial [da] Rep\u00fablica Federativa do Brasil. (Dec 20, 1996). https:\/\/www.planalto.gov.br\/ccivil_03\/leis\/l9394.htm. Accessed 04 Feb 2019."},{"issue":"40","key":"602_CR20","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1590\/S1413-24782009000100009","volume":"14","author":"JAB Bezerra","year":"2009","unstructured":"Bezerra JAB. Alimenta\u00e7\u00e3o e escola: significados e implica\u00e7\u00f5es curriculares da merenda escolar. Rev Bras Educ. 2009;14(40):103\u201315.","journal-title":"Rev Bras Educ."},{"issue":"4","key":"602_CR21","first-page":"108","volume":"14","author":"DT Da Cunha","year":"2012","unstructured":"Da Cunha DT, Stedefeldt E, De Rosso VV. Boas pr\u00e1ticas e qualidade microbiol\u00f3gica nos servi\u00e7os de alimenta\u00e7\u00e3o escolar: uma revis\u00e3o sistem\u00e1tica. Rev Bras Pesqui em Sa\u00fade. 2012;14(4):108\u201321.","journal-title":"Rev Bras Pesqui em Sa\u00fade."},{"issue":"1","key":"602_CR22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1756-3305-7-440","volume":"7","author":"F Chammartin","year":"2014","unstructured":"Chammartin F, Guimar\u00e3es LH, Scholte RGC, Bavia ME, Utzinger J, Vounatsou P. Spatio-temporal distribution of soil-transmitted helminth infections in Brazil. Parasit Vectors. 2014;7(1):1\u201316.","journal-title":"Parasit Vectors."},{"issue":"1","key":"602_CR23","doi-asserted-by":"publisher","first-page":"97","DOI":"10.4081\/gh.2013.58","volume":"8","author":"RGC Scholte","year":"2013","unstructured":"Scholte RGC, Schur N, Bavia ME, Carvalho EM, Chammartin F, Utzinger J, et al. Spatial analysis and risk mapping of soil-transmitted helminth infections in Brazil, using Bayesian geostatistical models. Geospat Health. 2013;8(1):97\u2013110.","journal-title":"Geospat Health."},{"issue":"8","key":"602_CR24","doi-asserted-by":"publisher","first-page":"e1001709","DOI":"10.1371\/journal.pmed.1001709","volume":"11","author":"SR Patil","year":"2015","unstructured":"Patil SR, Arnold BF, Salvatore AL, Briceno B, Ganguly S, Colford JM, et al. The effect of India\u2019s total sanitation campaign on defecation behaviors and child health in rural Madhya Pradesh: A cluster randomized controlled trial. PLoS Med. 2015;11(8):e1001709.","journal-title":"PLoS Med"},{"issue":"11","key":"602_CR25","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1016\/S2214-109X(14)70307-9","volume":"2","author":"T Clasen","year":"2014","unstructured":"Clasen T, Boisson S, Routray P, Torondel B, Bell M, Cumming O, et al. Effectiveness of a rural sanitation programme on diarrhoea, soil-transmitted helminth infection, and child malnutrition in Odisha, India: a cluster-randomised trial. Lancet Glob Heal. 2014;2(11):645\u201353.","journal-title":"Lancet Glob Heal."},{"issue":"2","key":"602_CR26","doi-asserted-by":"publisher","first-page":"020402","DOI":"10.7189\/jogh.09.020402","volume":"9","author":"AN Chard","year":"2019","unstructured":"Chard AN, Garn JV, Chang HH, Clasen T, Freeman MC. Impact of a school-based water, sanitation, and hygiene intervention on school absence, diarrhea, respiratory infection, and soil-transmitted helminths: results from the WASH HELPS cluster-randomized trial. J Glob Health. 2019;9(2):020402.","journal-title":"J Glob Health."},{"key":"602_CR27","unstructured":"Brazilian Institute of Geography and Statistics (IBGE). S\u00edntese de indicadores sociais: uma an\u00e1lise das condi\u00e7\u00f5es de vida da popula\u00e7\u00e3o brasileira. Rio de Janeiro. 2018. https:\/\/biblioteca.ibge.gov.br\/visualizacao\/livros\/liv101459.pdf. Accessed 04 Feb 2019."},{"issue":"1","key":"602_CR28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1756-3305-5-81","volume":"5","author":"RL Pullan","year":"2012","unstructured":"Pullan RL, Brooker SJ. The global limits and population at risk of soil-transmitted helminth infections in 2010. Parasit Vectors. 2012;5(1):1\u201314.","journal-title":"Parasit Vectors."},{"issue":"3","key":"602_CR29","doi-asserted-by":"publisher","first-page":"955","DOI":"10.1590\/S0103-73312011000300011","volume":"21","author":"FM Addum","year":"2011","unstructured":"Addum FM, Serra CG, Sessa KS, Izoton LM, Santos TB. Planejamento local, Sa\u00fade Ambiental e Estrat\u00e9gia Sa\u00fade da Fam\u00edlia: uma an\u00e1lise do uso de ferramentas de gest\u00e3o para a redu\u00e7\u00e3o do risco de contamina\u00e7\u00e3o por enteroparasitoses no munic\u00edpio de Venda Nova do Imigrante. Physis Rev Sa\u00fade Coletiva. 2011;21(3):955\u201378.","journal-title":"Physis Rev Sa\u00fade Coletiva."},{"key":"602_CR30","unstructured":"United Nations (UN). Resolution adopted by the General Assembly on 28 July 2010. Resolution A\/RES\/64\/292. The human right to water and sanitation. 2010. https:\/\/www.un.org\/en\/ga\/search\/view_doc.asp?symbol=A\/RES\/64\/292. Accessed 04 Feb 2019."},{"key":"602_CR31","unstructured":"Estabelece as diretrizes nacionais para o saneamento b\u00e1sico, cria o Comit\u00ea Interministerial de Saneamento B\u00e1sico, altera a Lei n\u00ba 6.766, de 19 de dezembro de 1979, a Lei n\u00ba 8.036, de 11 de maio de 1990, a Lei n\u00ba 8.666, de 21 de junho de 1993, e a Lei n\u00ba 8.987, de 13 de fevereiro de 1995, e revoga a Lei n\u00ba 6.528, de 11 de maio de 1978. Pub.L. N\u00ba 11.445. Di\u00e1rio Oficial [da] Rep\u00fablica Federativa do Brasil, Bras\u00edlia. (Jan 5, 2007). https:\/\/www.planalto.gov.br\/ccivil_03\/_ato2007-2010\/2007\/lei\/l11445.html. Accessed 04 Feb 2019."}],"container-title":["Archives of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13690-021-00602-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13690-021-00602-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13690-021-00602-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T20:02:42Z","timestamp":1621454562000},"score":1,"resource":{"primary":{"URL":"https:\/\/archpublichealth.biomedcentral.com\/articles\/10.1186\/s13690-021-00602-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,19]]},"references-count":31,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["602"],"URL":"https:\/\/doi.org\/10.1186\/s13690-021-00602-7","relation":{},"ISSN":["2049-3258"],"issn-type":[{"type":"electronic","value":"2049-3258"}],"subject":[],"published":{"date-parts":[[2021,5,19]]},"assertion":[{"value":"24 September 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 May 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 May 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The current study used data from the National Survey on the Prevalence of Schistosomiasis mansoni and Soil-transmitted helminth infections. These data are anonymous and available for research purposes by the Brazilian government. Moreover, The National Survey was approved by the Ethics and Research Committee of the Ren\u00e9 Rachou Research Center \u2013 Oswaldo Cruz Foundation and the National Research Ethics Commission \u2013 CONEP. Informed consent for participation was obtained from the parents of the schoolchildren.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interest"}}],"article-number":"83"}}