Research Paper An evaluation of water, sanitation, and hygiene status and household assets and their associations with soil- transmitted helminthiasis and reported diarrhea in Nueva Santa Rosa, Guatemala Gouthami Rao, Anna J. Blackstock, Gordana Derado, Victoria M. Cuéllar, Patricia Juliao, Maricruz Alvarez, Beatriz López, Fredy Muñoz, Andrew Thornton, Jaymin C. Patel, Gerard Lopez, Jose G. Rivera, Lissette Reyes, Wences Arvelo, Kim A. Lindblade and Sharon L. Roy ABSTRACT Soil-transmitted helminth (STH) infections and diarrheal illness affect billions of people yearly. We conducted a cross-sectional survey in Nueva Santa Rosa, Guatemala to identify factors associated with STH infections and diarrhea using univariable and multivariable logistic regression models. On multivariable analyses, we found associations between STH infections and two factors: school-aged children (odds ratio (OR) vs. adults: 2.35, 95% CI 1.10–4.99) and household drinking water supply classified as ‘other improved’ (OR vs. ‘improved’: 7.00, CI 1.22–40.14). Finished floors in the household vs. natural floors were highly protective (OR 0.16, CI 0.05–0.50) for STH infection. In crowded households (>2.5 people/bedroom), observing water present at handwashing stations was also protective (OR 0.32, CI 0.11–0.98). When adjusted for drying hands, diarrhea was associated with preschool-age children (OR vs. adults: 3.33, CI 1.83–6.04), spending >10 min per round trip collecting water (OR 1.90, CI 1.02–3.56), and having a handwashing station 10 m near a sanitation facility (OR 3.69, CI 1.33–10.21). Our study indicates that familiar WASH interventions, such as increasing drinking water quantity and water at handwashing stations in crowded homes, coupled with a hygiene intervention like finished flooring may hold promise for STH and diarrhea control programs. Key words | diarrhea, Guatemala, hygiene, sanitation, soil-transmitted helminths, water HIGHLIGHTS • School-aged children had over 2× the odds of STH infection than adults in our study. • ‘Other improved’ water as household drinking water was associated with 7× the odds of developing STH infection compared with ‘improved’ water. • Households with finished floors were protective for STH infection compared with natural floors. • Improved WASH interventions need consideration for STH and diarrheal disease control programs. Gouthami Rao (corresponding author) Anna J. Blackstock Gordana Derado Victoria M. Cuéllar Andrew Thornton Jaymin C. Patel Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA E-mail: www8@cdc.gov Patricia Juliao Gerard Lopez Wences Arvelo Kim A. Lindblade CDC Regional Office for Central America and Panama, Guatemala City 01015, Guatemala Maricruz Alvarez Beatriz López Fredy Muñoz Jose G. Rivera Universidad del Valle de Guatemala, Guatemala City 01015, Guatemala Lissette Reyes Health Area of Santa Rosa, Ministry of Public Health and Social Welfare, Guatemala City, Guatemala Sharon L. Roy Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence (CC BY 4.0), which permits copying, adaptation and redistribution, provided the original work is properly cited (http://creativecommons.org/licenses/by/4.0/). 362 Research Paper © 2021 The Authors Journal of Water, Sanitation and Hygiene for Development | 11.3 | 2021 doi: 10.2166/washdev.2021.160 Downloaded from http://iwaponline.com/washdev/article-pdf/11/3/362/889921/washdev0110362.pdf by guest on 06 November 2022