{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T17:43:45Z","timestamp":1792691025885,"version":"4.5.0"},"reference-count":76,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>\n                    Soil-transmitted helminths (STH) are parasitic intestinal worms infecting humans through contact with, or ingestion of, soil contaminated with eggs shed by infected individuals. STHs include roundworms (\n                    <jats:italic>Ascaris lumbricoides, Strongyloides stercoralis),<\/jats:italic>\n                    whipworm (\n                    <jats:italic>Trichuris trichiura<\/jats:italic>\n                    ) and hookworms (\n                    <jats:italic>Ancylostoma duodenale<\/jats:italic>\n                    ,\n                    <jats:italic>Necator americanus, Ancylostoma ceylanicum<\/jats:italic>\n                    ). Their transmission is influenced by water, sanitation and hygiene (WASH) services and practices. Unlike past reviews, this scoping review did not assess effect sizes or strength of associations. Instead, it aimed to: map WASH-related risk factors in relation to STH infection; assess whether these align with plausible transmission pathways and conceptual frameworks; and characterise methodological features of the evidence base, including diagnostic approaches, that affect comparability of findings. We analysed 197 studies, of which 174 were observational and 23 were intervention studies. We found a substantial and growing body of evidence examining the relationship between WASH and other environmental exposures and the prevalence and intensity of STH infection. Nonetheless, important aspects such as food chain pathways, environmental surveillance, under-studied species, and measures of service and infrastructure uptake and use, quality, and community coverage over time, remain under-investigated, hampering drawing practical conclusions for improvement of service delivery. Existing and new research can be enhanced in several areas. Routine investigations like prevalence surveys should apply standard WASH definitions to reduce heterogeneity, and apply a conceptual framework of transmission in study design. Intervention studies should be based on theories of change that map actions disrupting transmission pathways, implementing a comprehensive intervention package and examining factors affecting behaviours or intervention compliance. Evaluation of intervention uptake should also be included. New research should address the evidence gaps identified, and incorporate timelines with realistic likelihood of impact into study planning and proposals, given the environmental persistence of certain STH species and the fact that developing lasting and sustained behaviour change can be slow.\n                  <\/jats:p>","DOI":"10.1371\/journal.pgph.0006196","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T17:26:40Z","timestamp":1792690000000},"page":"e0006196","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Water, sanitation, and hygiene in soil-transmitted helminth control: A scoping review of evidence gaps across transmission pathways"],"prefix":"10.1371","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0075-2424","authenticated-orcid":true,"given":"Yael","family":"Velleman","sequence":"first","affiliation":[{"name":"Unlimit Health","place":["London, United Kingdom"],"department":["Policy and Innovation Team"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2556-0202","authenticated-orcid":true,"given":"Anne","family":"Straily","sequence":"additional","affiliation":[{"name":"US Centers for Disease Control and Prevention","place":["Atlanta, Georgia, United States of America"],"department":["Division of Parasitic Diseases and Malaria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0584-5961","authenticated-orcid":true,"given":"W. Evan","family":"Secor","sequence":"additional","affiliation":[{"name":"US Centers for Disease Control and Prevention","place":["Atlanta, Georgia, United States of America"],"department":["Division of Parasitic Diseases and Malaria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2399-7785","authenticated-orcid":true,"given":"Susana","family":"Vaz Nery","sequence":"additional","affiliation":[{"name":"The Kirby Institute","place":["Sydney, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9319-0859","authenticated-orcid":true,"given":"Laura","family":"Braun","sequence":"additional","affiliation":[{"name":"Environmental Health Group, London School of Hygiene and Tropical Medicine","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,10,22]]},"reference":[{"key":"pgph.0006196.ref001","volume-title":"Assessing schistosomiasis and soil-transmitted helminthiases control programmes: Monitoring and evaluation framework","year":"2024"},{"key":"pgph.0006196.ref002","volume-title":"WHO guideline on preventive chemotherapy for public health control of strongyloidiasis","year":"2024"},{"issue":"9521","key":"pgph.0006196.ref003","doi-asserted-by":"crossref","first-page":"1521","DOI":"10.1016\/S0140-6736(06)68653-4","article-title":"Soil-transmitted helminth infections: Ascariasis, trichuriasis, and hookworm","volume":"367","author":"J Bethony","year":"2006","journal-title":"Lancet"},{"key":"pgph.0006196.ref004","volume-title":"Ending the neglect to attain the sustainable development goals: A road map for neglected tropical diseases 2021-2030","year":"2020"},{"issue":"3","key":"pgph.0006196.ref005","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1001620","article-title":"Water, sanitation, hygiene, and soil-transmitted helminth infection: A systematic review and meta-analysis","volume":"11","author":"EC Strunz","year":"2014","journal-title":"PLoS Med"},{"issue":"6","key":"pgph.0006196.ref006","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1016\/j.ijheh.2017.05.007","article-title":"The impact of sanitation on infectious disease and nutritional status: A systematic review and meta-analysis","volume":"220","author":"MC Freeman","year":"2017","journal-title":"Int J Hyg Environ Health"},{"issue":"1","key":"pgph.0006196.ref007","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1186\/s13071-019-3532-6","article-title":"The role of water, sanitation and hygiene interventions in reducing soil-transmitted helminths: Interpreting the evidence and identifying next steps","volume":"12","author":"S Vaz Nery","year":"2019","journal-title":"Parasit Vectors"},{"issue":"6","key":"pgph.0006196.ref008","article-title":"Interventions to improve water, sanitation, and hygiene for preventing soil-transmitted helminth infection","volume":"6","author":"JV Garn","year":"2022","journal-title":"Cochrane Database Syst Rev"},{"key":"pgph.0006196.ref009","volume-title":"Guideline: Preventive chemotherapy to control soil-transmitted helminth infections in at-risk population groups","year":"2017"},{"key":"pgph.0006196.ref010","unstructured":"World Health Organization. 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