Publications by authors named "H Legge"

Background: Soil-transmitted helminths (STH) affect approximately 1.5 billion people globally. The current STH control strategy is annual or twice-annual preventive chemotherapy, typically school-based deworming targeting children and women of reproductive age.

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Article Synopsis
  • School-based health services may inadvertently exclude children with disabilities, while community-based approaches provide a more inclusive option for addressing their needs.
  • The study focuses on assessing disability prevalence among children aged 5-17 in Malawi and compares the effectiveness of school-based deworming (SBD) versus community-based deworming (CBD) for treating soil-transmitted helminths in these children.
  • Findings show a 3.3% disability prevalence, mainly affecting hearing, remembering, and communication, with boys more likely to have disabilities, which corresponded with lower school attendance and poorer health outcomes.
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Observational evidence suggests that household floors may be an important domain for the transmission of enteric and parasitic infections. However, little work has been done to investigate how household floors can become contaminated with human and animal faeces. This study uses a mixed methods approach to postulate the proximal and distal determinants of household floor contamination with faeces in groups of rural villages in 3 counties in Kenya (Bungoma, Kwale and Narok).

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Article Synopsis
  • Soil-transmitted helminth infections lead to significant health issues in low-and-middle-income countries, and WHO recommends periodic deworming, especially for children and women of reproductive age.
  • The study explored factors affecting the effectiveness of community-wide mass drug administration (cMDA) for deworming in high-coverage versus low-coverage areas in Benin, India, and Malawi using both qualitative and quantitative methods.
  • Eleven key factors, including community experiences with previous programs and women's decision-making authority, were identified as significant in determining the success of cMDA coverage.
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Enteric and parasitic infections such as soil-transmitted helminths cause considerable mortality and morbidity in low- and middle-income settings. Earthen household floors are common in many of these settings and could serve as a reservoir for enteric and parasitic pathogens, which can easily be transmitted to new hosts through direct or indirect contact. We conducted a systematic review and meta-analysis to establish whether and to what extent improved household floors decrease the odds of enteric and parasitic infections among occupants compared with occupants living in households with unimproved floors.

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