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COMMUNITY-WIDE REDUCTION IN PREVALENCE AND INTENSITY OF INTESTINAL HELMINTHS AS A COLLATERAL BENEFIT OF LYMPHATIC FILARIASIS ELIMINATION PROGRAMS

MADSEN BEAU DE ROCHARSHopital Ste. Croix, Leogane, Haiti; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Tropical Disease Research and Training, University of Notre Dame, Notre Dame, Indiana

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ABDEL N. DIRENYHopital Ste. Croix, Leogane, Haiti; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Tropical Disease Research and Training, University of Notre Dame, Notre Dame, Indiana

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JACQUELIN M. ROBERTSHopital Ste. Croix, Leogane, Haiti; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Tropical Disease Research and Training, University of Notre Dame, Notre Dame, Indiana

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DAVID G. ADDISSHopital Ste. Croix, Leogane, Haiti; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Tropical Disease Research and Training, University of Notre Dame, Notre Dame, Indiana

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JEANNE RADDAYHopital Ste. Croix, Leogane, Haiti; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Tropical Disease Research and Training, University of Notre Dame, Notre Dame, Indiana

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MICHAEL J. BEACHHopital Ste. Croix, Leogane, Haiti; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Tropical Disease Research and Training, University of Notre Dame, Notre Dame, Indiana

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THOMAS G. STREITHopital Ste. Croix, Leogane, Haiti; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Tropical Disease Research and Training, University of Notre Dame, Notre Dame, Indiana

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DESIRE DARDITHHopital Ste. Croix, Leogane, Haiti; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Tropical Disease Research and Training, University of Notre Dame, Notre Dame, Indiana

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JACK GUY LAFONTANTHopital Ste. Croix, Leogane, Haiti; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Tropical Disease Research and Training, University of Notre Dame, Notre Dame, Indiana

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PATRICK J. LAMMIEHopital Ste. Croix, Leogane, Haiti; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Center for Tropical Disease Research and Training, University of Notre Dame, Notre Dame, Indiana

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Annual mass treatment with antifilarial drugs is the cornerstone of the global program to eliminate lymphatic filariasis (LF). Although the primary goal of the program is to interrupt transmission of LF, additional public health benefits also are expected because of the known anthelminthic properties of these drugs. Since rapid re-infection with intestinal helminths occurs following treatment, annual de-worming may not be sufficient to produce a lasting reduction in the prevalence and intensity of these infections. We conducted stool examinations in four sentinel communities before and approximately nine months after each of two rounds of mass drug administration (MDA) with diethylcarbamazine and albendazole in the context of an LF elimination program in Leogane, Haiti. At baseline, overall Ascaris, Trichuris, and hookworm infection prevalences were 20.9%, 34.0%, and 11.2%, respectively (n = 2,716 stools). Nine months after the second MDA, Ascaris, Trichuris and hookworm prevalences had decreased significantly, to 14.1%, 14.6%, and 2.0%, respectively (n = 814 stools). Infection intensity decreased significantly for all three parasites as well. These results demonstrate that substantial reductions in intestinal helminth infections are associated with mass treatment of filariasis in Haiti and are consistent with the conclusion that high levels of coverage for the LF program can decrease transmission of geohelminths.

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