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GEOGRAPHIC DISTRIBUTION OF SCHISTOSOMIASIS AND SOIL-TRANSMITTED HELMINTHS IN WESTERN KENYA: IMPLICATIONS FOR ANTHELMINTHIC MASS TREATMENT

THOMAS HANDZELEpidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program Office and Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya

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DIANA M. S. KARANJAEpidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program Office and Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya

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DAVID G. ADDISSEpidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program Office and Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya

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ALLEN W. HIGHTOWEREpidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program Office and Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya

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DANIEL H. ROSENEpidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program Office and Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya

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DANIEL G. COLLEYEpidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program Office and Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya

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JULIUS ANDOVEEpidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program Office and Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya

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LAURENCE SLUTSKEREpidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program Office and Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya

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W. EVAN SECOREpidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program Office and Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya

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A survey of 1,246 children 10–12 years old in 32 primary schools in Kenya near Lake Victoria was conducted to determine prevalence and distribution of schistosome and geohelminth infections. Stool and urine samples were collected and examined for eggs of Schistosoma mansoni, S. haematobium, and intestinal helminths. A questionnaire was used to obtain demographic information and to quantify exposure to surface waters. Houses, schools, and water sources were mapped using a geographic information system. The mean school prevalence of S. mansoni infection was 16.3% (range = 0–80%). Proximity to the lake (r = 0.89, P < 0.001) and contact with lake water were associated with infection, as were specific water-related activities including swimming, fishing, and collecting water. Sixty-three percent of students were infected with one or more other geohelminths and these infections were more homogenously distributed. The separate distributions of schistosome and geohelminth infections have important implications for combined mass-treatment programs.

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