BACKGROUND In Bangladesh, preventive chemotherapy targeting soil-transmitted helminth (STH) infections in school-age children has been implemented since 2008. To evaluate the success of this strategy, surveys were conducted between 2017 and 2020 in 10 out of 64 districts. We estimate the geographic distribution of STH infections by species at high spatial resolution, identify risk factors, and estimate treatment needs at different population subgroups. METHODOLOGY Bayesian geostatistical models were fitted to prevalence data of each STH species. Climatic, environmental, and socioeconomic predictors were extracted from satellite images, open-access, model-based databases, and demographic household surveys, and used to predict the prevalence of infection over a gridded surface at 1 x 1 km spatial resolution across the country, via Bayesian kriging. These estimates were combined with gridded population data to estimate the number of required treatments for different risk groups. PRINCIPAL FINDINGS The population-adjusted prevalence of Ascaris lumbricoides, Trichuris trichiura, and hookworm across all ages is estimated at 9.9% (95% Bayesian credible interval: 8.0-13.0%), 4.3% (3.0-7.3%), and 0.6% (0.4-0.9%), respectively. There were 24 out of 64 districts with an estimated population-adjusted STH infection prevalence above 20%. The proportion of households with improved sanitation showed a statistically important, protective association for both, A. lumbricoides and T. trichiura prevalence. Precipitation in the driest month of the year was negatively associated with A. lumbricoides prevalence. High organic carbon concentration in the soil's fine earth fraction was related to a high hookworm prevalence. Furthermore, we estimated that 30.5 (27.2; 36.0) million dosages of anthelmintic treatments for school-age children were required per year in Bangladesh. CONCLUSIONS/SIGNIFICANCE For each of the STH species, the prevalence was reduced by at least 80% since treatment was scaled up more than a decade ago. The current number of deworming dosages could be reduced by up to 61% if the treatment strategy was adapted to the local prevalence.

中文翻译：

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孟加拉国土源性蠕虫病的分布和治疗需求：2017-2020年全国调查数据的贝叶斯地统计分析。

背景 在孟加拉国，自 2008 年以来一直针对学龄儿童土源性蠕虫 (STH) 感染实施预防性化疗。为了评估这一策略的成功程度，2017 年至 2020 年间在 64 个地区中的 10 个地区进行了调查。我们以高空间分辨率估计了按物种划分的 STH 感染的地理分布，确定了风险因素，并估计了不同人群亚组的治疗需求。方法学 贝叶斯地统计模型适合每个 STH 物种的流行数据。从卫星图像、开放获取、基于模型的数据库和人口家庭调查中提取气候、环境和社会经济预测因素，并用于预测全国范围内 1 x 1 公里空间分辨率的网格表面上的感染流行率，通过贝叶斯克里金法。这些估计与网格人口数据相结合，以估计不同风险群体所需治疗的数量。主要发现 所有年龄段的蛔虫、毛虫和钩虫的人群调整患病率估计分别为 9.9%（95% 贝叶斯可信区间：8.0-13.0%）、4.3%（3.0-7.3%）和 0.6%（ 0.4-0.9%），分别。64 个地区中有 24 个地区的人口调整后 STH 感染率估计超过 20%。卫生条件得到改善的家庭比例显示出统计上重要的保护性关联，这对线虫和毛线虫的流行率具有重要意义。一年中最干燥月份的降水量与蚓螈的流行呈负相关。土壤细土部分的高有机碳浓度与钩虫的高流行有关。此外，我们估计孟加拉国每年需要为学龄儿童提供 30.5（27.2；36.0）百万剂驱虫药。结论/意义 对于每种 STH 物种，自十多年前扩大治疗规模以来，患病率至少降低了 80%。如果治疗策略适应当地流行情况，目前的驱虫剂量最多可减少 61%。