{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T07:37:35Z","timestamp":1780731455420,"version":"3.54.1"},"update-to":[{"DOI":"10.1371\/journal.pntd.0013467","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T00:00:00Z","timestamp":1758499200000}}],"reference-count":54,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T00:00:00Z","timestamp":1757289600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004331","name":"Johnson and Johnson","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004331","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Soil-transmitted helminth (STH) infections remain a public health problem in Uganda despite biannual national deworming campaigns implemented since the early 2000s. Recent surveys have indicated a heterogeneous STH infection prevalence, suggesting that the current blanket deworming strategy may no longer be cost-effective. This study identified infection predictors, estimated the geographic distribution of STH infection prevalence by species, and calculated deworming needs for school-age children (SAC).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methodology<\/jats:title>\n<jats:p>Bayesian geostatistical models were applied to STH survey data (2021\u20132023) for each species (i.e., <jats:italic><jats:italic>Ascaris lumbricoides<\/jats:italic><\/jats:italic>, hookworm, and <jats:italic><jats:italic>Trichuris trichiura<\/jats:italic><\/jats:italic>). Climatic, environmental, and socioeconomic predictors were obtained from remote sensing sources, model-based databases, and demographic and health surveys. Prevalence was predicted on a 1\u2009\u00d7\u20091 km<jats:sup>2<\/jats:sup> grid across Uganda, and district-level estimates were used to classify each district into treatment frequency categories and to determine its deworming tablet requirements.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Principal findings<\/jats:title>\n<jats:p>The national prevalence of <jats:italic><jats:italic>A. lumbricoides<\/jats:italic><\/jats:italic>, <jats:italic><jats:italic>T. trichiura,<\/jats:italic><\/jats:italic> and hookworm was estimated at 5.0% (95% Bayesian credible interval [BCI]: 0.8\u201311.8%), 3.5% (0.7\u20139.3%), and 7.2% (5.7\u201311.1%), respectively. The overall prevalence of any STH infection was 14.3% (9.6\u201321.8%). High intra-district variation in prevalence was observed. Of 146 implementation units (136 districts and 10 cities), 49 require twice-year treatment, 34 once-yearly treatment, 61 every other year treatment, and 2 had a prevalence &lt;2%, indicating treatment suspension or event-based treatment. Approximately 17 million tablets will be needed for preventive chemotherapy aimed at SAC in 2025.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions\/significance<\/jats:title>\n<jats:p>The prevalence of STH infection has declined considerably across Uganda compared to the early 2000s. However, deworming needs remain heterogeneous across districts. Through geostatistical modeling, districts were classified according to the latest World Health Organization\u2019s (WHO) treatment guidelines. This approach optimizes treatment distribution and allows for prioritization of populations with the greatest needs. We estimated that tablet requirements are approximately 40% lower compared to the current twice-a-year deworming regimen, which contributes towards WHO\u2019s goal of halving the number of tablets required for preventive chemotherapy by 2030.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0013467","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T18:04:37Z","timestamp":1757354677000},"page":"e0013467","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Geostatistical analysis to guide treatment decisions for soil-transmitted helminthiasis control in Uganda"],"prefix":"10.1371","volume":"19","author":[{"given":"Bryan O.","family":"Nyawanda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin M.","family":"Sullivan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Tinkitina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prudence","family":"Beinamaryo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Betty","family":"Nabatte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilda","family":"Kyarisiima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred","family":"Mubangizi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul M.","family":"Emerson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrg","family":"Utzinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4904-5352","authenticated-orcid":true,"given":"Penelope","family":"Vounatsou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,9,8]]},"reference":[{"issue":"4","key":"pntd.0013467.ref001","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2017-021319","article-title":"Soil-transmitted helminth infections and nutritional status in Ecuador: findings from a national survey and implications for control strategies","volume":"8","author":"AL Moncayo","year":"2018","journal-title":"BMJ Open"},{"key":"pntd.0013467.ref002","doi-asserted-by":"crossref","first-page":"1283054","DOI":"10.3389\/fpubh.2024.1283054","article-title":"Prevalence and correlates of soil-transmitted helminths in schoolchildren aged 5 to 18\u2009years in low- and middle-income countries: a systematic review and meta-analysis","volume":"12","author":"R Agrawal","year":"2024","journal-title":"Front Public Health"},{"issue":"8","key":"pntd.0013467.ref003","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0008505","article-title":"The global progress of soil-transmitted helminthiases control in 2020 and World Health Organization targets for 2030","volume":"14","author":"A Montresor","year":"2020","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0013467.ref004","unstructured":"World Health Organization. Soil-transmitted helminth infections. 2023 [cited 2024 October 10]. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/soil-transmitted-helminth-infections"},{"key":"pntd.0013467.ref005","unstructured":"World Health Organization. Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN). 2024 [cited 2024 November 8]. https:\/\/espen.afro.who.int"},{"issue":"10117","key":"pntd.0013467.ref006","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/S0140-6736(17)31930-X","article-title":"Soil-transmitted helminth infections","volume":"391","author":"PM Jourdan","year":"2018","journal-title":"Lancet"},{"issue":"11","key":"pntd.0013467.ref007","article-title":"Distribution and treatment needs of soil-transmitted helminthiasis in Bangladesh: a\u00a0Bayesian geostatistical analysis of 2017-2020 national survey data","volume":"17","author":"DJF Gerber","year":"2023","journal-title":"PLoS Negl Trop Dis"},{"issue":"1","key":"pntd.0013467.ref008","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/s41182-022-00436-1","article-title":"Epidemiology of soil-transmitted helminthiasis and associated malnutrition among under-fives in conflict affected areas in southern Ethiopia","volume":"50","author":"GE Geleto","year":"2022","journal-title":"Trop Med Health"},{"key":"pntd.0013467.ref009","volume-title":"Prevention and control of schistosomiasis and soil-transmitted helminthiasis: report of a WHO expert committee","author":"WHO Expert Committee on the Control of Schistosomiasis","year":"2002"},{"issue":"1","key":"pntd.0013467.ref010","doi-asserted-by":"crossref","DOI":"10.1016\/S2214-109X(20)30398-3","article-title":"Prevalence and intensity of soil-transmitted helminth infections of children in sub-Saharan Africa, 2000-18: a geospatial analysis","volume":"9","author":"B Sartorius","year":"2020","journal-title":"Lancet Glob Health"},{"key":"pntd.0013467.ref011","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/bs.apar.2019.02.004","article-title":"Diagnosis and drug resistance of human soil-transmitted helminth infections: a public health perspective","volume":"104","author":"PN Mutombo","year":"2019","journal-title":"Adv Parasitol"},{"issue":"4","key":"pntd.0013467.ref012","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0006296","article-title":"Review of the 2017 WHO guideline: preventive chemotherapy to control soil-transmitted helminth infections in at-risk population groups. An opportunity lost in translation","volume":"12","author":"L Savioli","year":"2018","journal-title":"PLoS Negl Trop Dis"},{"issue":"9","key":"pntd.0013467.ref013","doi-asserted-by":"crossref","DOI":"10.1016\/S2214-109X(19)30253-0","article-title":"Reassessment of the prevalence of soil-transmitted helminth infections in Sri Lanka to enable a more focused control programme: a cross-sectional national school survey with spatial modelling","volume":"7","author":"DS Ediriweera","year":"2019","journal-title":"Lancet Glob Health"},{"key":"pntd.0013467.ref014","volume-title":"Assessing schistosomiasis and soil-transmitted helminthiases control programmes","author":"World Health Organization","year":"2024"},{"issue":"8","key":"pntd.0013467.ref015","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0012324","article-title":"Prevalence and intensity of soil-transmitted helminth infections among school-aged children in five districts in Uganda","volume":"18","author":"B Tinkitina","year":"2024","journal-title":"PLoS Negl Trop Dis"},{"issue":"9","key":"pntd.0013467.ref016","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0011605","article-title":"Prevalence and intensity of soil-transmitted helminth infections in Uganda: results from population-based prevalence surveys in five districts","volume":"17","author":"B Tinkitina","year":"2023","journal-title":"PLoS Negl Trop Dis"},{"issue":"2","key":"pntd.0013467.ref017","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.actatropica.2013.04.012","article-title":"Statistical methodological issues in mapping historical schistosomiasis survey data","volume":"128","author":"F Chammartin","year":"2013","journal-title":"Acta Trop"},{"issue":"6","key":"pntd.0013467.ref018","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/S1473-3099(13)70071-9","article-title":"Soil-transmitted helminth infection in South America: a systematic review and geostatistical meta-analysis","volume":"13","author":"F Chammartin","year":"2013","journal-title":"Lancet Infect Dis"},{"key":"pntd.0013467.ref019","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1186\/s13071-016-1446-0","article-title":"Bayesian risk profiling of soil-transmitted helminth infections and estimates of preventive chemotherapy for school-aged children in C\u00f4te d\u2019Ivoire","volume":"9","author":"RB Yapi","year":"2016","journal-title":"Parasit Vectors"},{"key":"pntd.0013467.ref020","volume-title":"The National Population and Housing Census 2024 \u2013 Preliminary Report","author":"Uganda Bureau of Statistics","year":"2024"},{"key":"pntd.0013467.ref021","volume-title":"MOD11A2 MODIS\/Terra Land Surface Temperature\/Emissivity 8-Day L3 Global 1km SIN Grid V006","author":"Z Wan","year":"2015"},{"key":"pntd.0013467.ref022","doi-asserted-by":"crossref","first-page":"150066","DOI":"10.1038\/sdata.2015.66","article-title":"The climate hazards infrared precipitation with stations--a new environmental record for monitoring extremes","volume":"2","author":"C Funk","year":"2015","journal-title":"Sci Data"},{"key":"pntd.0013467.ref023","author":"K Didan","year":"2021","journal-title":"MODIS\/Terra Vegetation Indices Monthly L3 Global 1km SIN Grid V061"},{"key":"pntd.0013467.ref024","volume-title":"VIIRS Day\/Night Band Monthly Composites Version 1","author":"Google Earth Engine","year":"2023"},{"key":"pntd.0013467.ref025","volume-title":"Uganda Demographic and Health Survey 2016","author":"Uganda Bureau of Statistics, ICF","year":"2018"},{"key":"pntd.0013467.ref026","volume-title":"Uganda Malaria Indicator Survey 2018-19","author":"Uganda National Malaria Control Division, Uganda Bureau of Statistics, ICF","year":"2020"},{"key":"pntd.0013467.ref027","unstructured":"Tropical Data. n.d. [cited 2024 November 25]. https:\/\/www.tropicaldata.org\/"},{"key":"pntd.0013467.ref028","author":"NASA","year":"2013","journal-title":"Shuttle Radar Topography Mission (SRTM) Global"},{"key":"pntd.0013467.ref029","unstructured":"SoilGrids \u2014 global gridded soil information. n.d. [cited 2024 November 13]. www.isric.org. https:\/\/www.isric.org\/explore\/soilgrids"},{"issue":"1","key":"pntd.0013467.ref030","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/j.1600-0587.2012.07348.x","article-title":"Collinearity: a review of methods to deal with it and a simulation study evaluating their performance","volume":"36","author":"CF Dormann","year":"2013","journal-title":"Ecography"},{"issue":"1","key":"pntd.0013467.ref031","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1890\/14-0661.1","article-title":"A guide to Bayesian model selection for ecologists","volume":"85","author":"MB Hooten","year":"2015","journal-title":"Ecological Monographs"},{"issue":"8","key":"pntd.0013467.ref032","article-title":"Risk profiling of soil-transmitted helminth infection and estimated number of infected people in South Asia: a systematic review and Bayesian geostatistical Analysis","volume":"13","author":"Y-S Lai","year":"2019","journal-title":"PLoS Negl Trop Dis"},{"issue":"4","key":"pntd.0013467.ref033","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0000655","article-title":"Using the prevalence of individual species of intestinal nematode worms to estimate the combined prevalence of any species","volume":"4","author":"N de Silva","year":"2010","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0013467.ref034","volume-title":"2030 targets for soil-transmitted helminthiases control programmes","author":"World Health Organization","year":"2020"},{"issue":"1","key":"pntd.0013467.ref035","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s12942-024-00381-8","article-title":"The influence of malaria control interventions and climate variability on changes in the geographical distribution of parasite prevalence in Kenya between 2015 and 2020","volume":"23","author":"BO Nyawanda","year":"2024","journal-title":"Int J Health Geogr"},{"key":"pntd.0013467.ref036","volume-title":"R: a language and environment for statistical computing","author":"Team R Core","year":"2025"},{"key":"pntd.0013467.ref037","doi-asserted-by":"crossref","DOI":"10.1002\/9781118950203","author":"M Blangiardo","year":"2015","journal-title":"Spatial and spatio-temporal Bayesian models with R-INLA"},{"key":"pntd.0013467.ref038","year":"n.d"},{"issue":"5","key":"pntd.0013467.ref039","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0005565","article-title":"An environmental assessment and risk map of Ascaris lumbricoides and Necator americanus distributions in Manufahi District, Timor-Leste","volume":"11","author":"R Wardell","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0013467.ref040","first-page":"100974","article-title":"Risk mapping and socio-ecological drivers of soil-transmitted helminth infections in the Philippines: a spatial modelling study","volume":"43","author":"T Tsheten","year":"2024","journal-title":"Lancet Reg Health West Pac"},{"key":"pntd.0013467.ref041","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.actatropica.2017.02.014","article-title":"Detection and quantification of soil-transmitted helminths in environmental samples: a review of current state-of-the-art and future perspectives","volume":"169","author":"ID Amoah","year":"2017","journal-title":"Acta Trop"},{"key":"pntd.0013467.ref042","first-page":"116","article-title":"Biology of soil-transmitted helminths: the massive infection","volume":"12","author":"PC Beaver","year":"1975","journal-title":"Health Lab Sci"},{"issue":"3","key":"pntd.0013467.ref043","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0092032","article-title":"Ascaris lumbricoides infection and its relation to environmental factors in the Mbeya region of Tanzania, a cross-sectional, population-based study","volume":"9","author":"SA Sch\u00fcle","year":"2014","journal-title":"PLoS One"},{"issue":"4","key":"pntd.0013467.ref044","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1007\/s00436-023-07809-3","article-title":"Soil-transmitted helminth infection among school-age children in Ogoja, Nigeria: implication for control","volume":"122","author":"EE Imalele","year":"2023","journal-title":"Parasitol Res"},{"key":"pntd.0013467.ref045","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.cegh.2020.08.003","article-title":"Hookworm infection still prevalent in the less developed urban area in Jakarta, Indonesia","volume":"9","author":"Celine","year":"2021","journal-title":"Clin Epidemiol and Glob Health"},{"issue":"10","key":"pntd.0013467.ref046","doi-asserted-by":"crossref","DOI":"10.1016\/S2214-109X(14)70300-6","article-title":"Effects of vector-control interventions on changes in risk of malaria parasitaemia in sub-Saharan Africa: a spatial and temporal analysis","volume":"2","author":"F Giardina","year":"2014","journal-title":"Lancet Glob Health"},{"issue":"1","key":"pntd.0013467.ref047","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1038\/s41572-020-0171-3","article-title":"Whipworm and roundworm infections","volume":"6","author":"KJ Else","year":"2020","journal-title":"Nat Rev Dis Primers"},{"key":"pntd.0013467.ref048","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1196\/annals.1425.000","article-title":"Hookworm and poverty","volume":"1136","author":"P Hotez","year":"2008","journal-title":"Ann N Y Acad Sci"},{"issue":"10","key":"pntd.0013467.ref049","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0012521","article-title":"Need for a paradigm shift in soil-transmitted helminthiasis control: targeting the right people, in the right place, and with the right drug(s)","volume":"18","author":"PM Emerson","year":"2024","journal-title":"PLoS Negl Trop Dis"},{"issue":"45","key":"pntd.0013467.ref050","doi-asserted-by":"crossref","first-page":"13892","DOI":"10.1073\/pnas.1518285112","article-title":"Why significant variables aren\u2019t automatically good predictors","volume":"112","author":"A Lo","year":"2015","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"4","key":"pntd.0013467.ref051","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1177\/0022343309356491","article-title":"The perils of policy by p-value: Predicting civil conflicts","volume":"47","author":"MD Ward","year":"2010","journal-title":"J. Peace Res"},{"issue":"4","key":"pntd.0013467.ref052","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.1093\/rfs\/hhm014","article-title":"A comprehensive look at the empirical performance of equity premium prediction","volume":"21","author":"I Welch","year":"2007","journal-title":"Rev Financ Stud"},{"issue":"3","key":"pntd.0013467.ref053","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1093\/sysbio\/syad004","article-title":"Identifying the best approximating model in Bayesian phylogenetics: Bayes factors, cross-validation or WAIC?","volume":"72","author":"N Lartillot","year":"2023","journal-title":"Syst Biol"},{"issue":"10","key":"pntd.0013467.ref054","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0010810","article-title":"Modeling the effect of different drugs and treatment regimen for hookworm on cure and egg reduction rates taking into account diagnostic error","volume":"16","author":"CM Grolimund","year":"2022","journal-title":"PLoS Negl Trop Dis"}],"updated-by":[{"DOI":"10.1371\/journal.pntd.0013467","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T00:00:00Z","timestamp":1758499200000}}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0013467","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T17:50:22Z","timestamp":1758563422000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0013467"}},"subtitle":[],"editor":[{"given":"David J.","family":"Diemert","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,9,8]]},"references-count":54,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9,8]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0013467","relation":{},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,8]]}}}