Market integration and soil-transmitted helminth infection among the Shuar of Amazonian Ecuador

Soil-transmitted helminth (STH) infections have many negative health outcomes (e.g., diarrhea, nutritional deficiencies) that can also exacerbate poverty. These infections are generally highest among low-income populations, many of which are also undergoing market integration (MI; increased particip...

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Bibliographic Details
Published in:PloS one 2020-07, Vol.15 (7), p.e0236924
Main Authors: Gildner, Theresa E, Cepon-Robins, Tara J, Liebert, Melissa A, Urlacher, Samuel S, Schrock, Joshua M, Harrington, Christopher J, Madimenos, Felicia C, Snodgrass, J. Josh, Sugiyama, Lawrence S
Format: Article
Language:English
Subjects:
Biology and Life Sciences
Diarrhea
Disease control
Disease spread
Earth Sciences
Economic integration
Environmental changes
Exposure
Feces
Forecasts and trends
Health aspects
Health risks
Helminthiasis
Households
Hypotheses
Impact analysis
Infections
Infectious diseases
Infrastructure
Integration
Jivaros
Lifestyles
Medicine and Health Sciences
Nutrient deficiency
Parasites
Pathogens
Population
Populations
Poverty
Public health administration
Regression analysis
Regression models
Residential areas
Risk factors
Soils
Tropical diseases
Viral infections
Wood floors
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Summary:Soil-transmitted helminth (STH) infections have many negative health outcomes (e.g., diarrhea, nutritional deficiencies) that can also exacerbate poverty. These infections are generally highest among low-income populations, many of which are also undergoing market integration (MI; increased participation in a market-based economy). Yet the direct impact of MI-related social and environmental changes on STH infection patterns is poorly understood, making it unclear which lifestyle factors should be targeted to better control disease spread. This cross-sectional study examines if household infrastructure associated with greater MI is associated with lower STH burdens among Indigenous Ecuadorian Shuar. Kato-Katz fecal smears were used to determine STH infection status and intensity (n = 620 participants; 308 females, 312 males, aged 6 months-86 years); Ascaris lumbricoides (ascarid) and Trichuris trichiura (whipworm) were the primary infection types detected. Structured interviews assessing lifestyle patterns (e.g., measures of household infrastructure) measured participant MI. Multilevel regression analyses and zero-inflated negative binomial regression models tested associations between MI measures and STH infection status or intensity, controlling for individual and community characteristics. This study documents associations between household measures and STH infection among an Indigenous population undergoing rapid MI. These findings can help healthcare programs better target interventions and reduce STH exposure among at-risk populations.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0236924