Intestinal Parasitic Infections and Wash Practices among School-Aged Children in Anaocha Local Government Area, Anambra State, Nigeria.
Main Article Content
Abstract
Intestinal parasitic infections (IPIs) remain a major public health problem among children in developing countries due to poor sanitation, inadequate water supply, and unhealthy hygiene practices. This study assessed the prevalence of intestinal parasitic infections and associated water, sanitation and hygiene (WASH), knowledge, attitude and practice (KAP) factors among school-aged children in Neni, Adazi-Enu, and Akwaeze communities of Anaocha Local Government Area, Anambra State, Nigeria. A total of 310 children aged 3-14 years participated in the study. Stool samples were examined using the Kato-Katz technique and wet mount microscopy, while structured questionnaire was used to obtain information on socio-demographic characteristics, WASH conditions, and KAP. Data were analysed using SPSS version 25 at a 95% confidence level. Of the 310 children examined, 96 (30.9%) were infected with at least one intestinal parasite. Ascaris lumbricoides was the predominant parasite (75.0%), followed by hookworm (10.4%), Taenia species (7.3%), Entamoeba histolytica (4.2%), and Trichuris trichiura (3.1%). Akwaeze recorded the highest prevalence, while Neni had the lowest. There was no significant association (P > 0.05) between infection prevalence and age or gender. WASH assessment revealed adequate status in Neni (71%), partial adequacy in Adazi-Enu (42%), and inadequate status in Akwaeze (28%). Akweze with the ‘inadequate WASH status’ had the highest prevalence (36%) of IPIs. There was significant association of availability of WASH components and prevalence of infections (p = 0.00001). Responses to administered questionnaire identified poor knowledge, open defecation, poor hand-washing practices, walking barefoot, nail biting, playing with soil, and consumption of unwashed fruits as important risk factors to IPIs. The relatively high prevalence of intestinal parasitic infections observed in the study highlights the need for improved sanitation, health education, provision of safe water, and regular deworming programmes to reduce the burden of infection among children in the study communities.
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Umeokpala, L. C., Uzochukwu, C. U., Obiefule, I. E., Umeanor, B. C., Ikpeoha, B. C., Chibuoke, P. O., & Chibuoke, P. O. (2026). Intestinal Parasitic Infections and Wash Practices among School-Aged Children in Anaocha Local Government Area, Anambra State, Nigeria. The Bioscientist Journal, 14(2), 347-369. https://doi.org/10.54117/the_bioscientist.v14i2.236
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References
Adu, A. M., Simpong, D. I. and Donkor, D. M. (2026). “Parasitic Infections and Associated Cognitive Outcome among School-Aged Children in Africa: A Systematic Review.” Brain and Behaviour, 16(4): e71326. https://doi.org/10.1002/brb3.71326
Ahmed, M. (2023). Intestinal Parasitic Infections in 2023. Gastroenterology Research, 16(3):127-140. doi: 10.14740/gr1622.
Ali, T., Sahar, G., Mahdi, J., Meysam, O., Amir, A. and Fatemeh, G. (2021). Global prevalence of intestinal parasitic infections and associated risk factors in pregnant women: a systematic review and meta-analysis, Transactions of The Royal Society of Tropical Medicine and Hygiene, 115(5), 457–470, https://doi.org/10.1093/trstmh/traa101
Alo, C., Akamike, I., Agbo, U., Eze, I., Madudueze, U., Okedo-Alex, I., Azuogu, B., Una, A., Elum, P., Ugochukwu, C., Nwonwu, E. and Ogbonnaya, L. (2021). Prevalence, Knowledge, Attitude and Preventive Practices Regarding Intestinal and Urinary Parasites among Primary School Children in a Rural Community in Ebonyi State, Nigeria. Journal of Epidemiological Society of Nigeria, 4(1), 39–50. https://doi.org/10.46912/jeson.39
Amisu, B. O., Okesanya, O. J., Olaleke, N. O., Ologun, C. O., Lucero-Prisno, D. E., Ogunwale, V. O., Ahuoyiza, R. A., Manirambona, E., Padhi, B. K. and Mewara, A. (2023). Socio-environmental determinants of parasitic intestinal infections among children: a cross-sectional study in Nigeria. Journal of Global Health Science, 5(1). https://doi.org/10.35500/jghs.2023.5.e6
Anthony, D., Biaton, D., Musa, A. D., Udofia, L. E. and Yakubu, E. D. (2022). A study on the gastrointestinal parasites (GIP) of wild animals found within the surrounding forests of Zuku and Rumfan Gwamna villages in Bassa Local Government Area, Plateau State, Nigeria. World Journal of Advanced Research and Reviews, 14(02), 384–392. https://doi.org/10.30574/wjarr.2022.14.2.0336
Aribodor, O. B., Jacob, E. C., Azugo, N. O., Ngenegbo, U. C., Obika, I., Obikwelu, E. M. and Nebe, O. J. (2025). Soil-transmitted helminthiasis among adolescents in Anaocha Local Government Area, Anambra State, Nigeria: Insights and recommendations for effective control. Public Library of Science ONE, 20(1), e0292146. https://doi.org/10.1371/journal.pone.0292146.
Atta, H. I., Isah, U., and Amadi, K. U. (2019). Prevalence of soil-transmitted helminths in children attending public primary schools in Samaru, Zaria, Nigeria. Federal University Wukari Trends in Science and Technology Journal, 4(1), 32–35. https://www.researchgate.net/profile/Habiba-Atta/publication/332844978
Bello, O. H. N., Odu, M. A., Okueso, S. A. and Kalesanwo, O. O. (2025). Assessment of usage of water, sanitation and hygiene facilities among public secondary school students in Ogun State. Journal of Humanities, Social Sciences and Creative Arts, 20, 80–86. https://journal.funaab.edu.ng/index.php/JHSSCA/article/view/2497
Cheesbrough, M. (2000, 2006). Parasitological tests. District Laboratory Practice in Tropical Countries; part 2. University Press, Cambridge, 239-258. https://scholar.archive.org/work/7ilsko6rbje5pg3bp7572pk7wq/access/wayback/http://isnra.com:80/ojs/index.php/M/article/download/47/14/
Chidozie, G. N., Egbuche, C. M., Amoke, C. O., Okeke, A. U., Egbuche, F. G., Obi, O. J., Chimezie, M. C., and Nwachukwu, C. A. (2025). ‘Irregular CDD’ and ‘Mosaic pattern of WASH’ activities towards ‘STH’ control: A case study of Aguleri, Anambra-East LGA, Anambra state, Nigeria. The Bioscientist, 13(2): 16 – 27.
Cochran, W.G. (1977). Sampling techniques (3rded). John Wiley and sons.
Egbuche, C. M., Chukwu, I., Ezihe, C. K., and Ngenegbo, U. C. (2017). Impact of Control Measures on the Prevalence of Intestinal Parasite Infections among Primary School Pupils. International Journal of Research in Pharmacy and Biosciences; 4(5): 1-5.
Egbuche, F. G., Iwueze, M. O., Egbuche, C. M., Anyasodor, A. E., and Amoke, O. C. (2024). Geohelminth Infections and Wash Practices among Primary School Pupils in Mgbakwu, Awka North LGA, Anambra State, Nigeria. The Bioscientist Journal, 12(1), 47-58. https://doi.org/10.54117/the_bioscientist.v12i1.165
Egbuche, C., Amoke, C., Okalu, U., Egbuche, F., Obiakor, U. and Chimezie, M. (2025). Status of School-Based Water, Sanitation, Hygiene (WASH) Resources and Soil Transmitted Helminth (STH) Infections in Rural Nigeria: A Pilot Study. Journal of Health and Environmental Research, 11(2): 38 – 47
Egbuche, C. M., Chidozie, G. N., Amoke, C. O., Okeke, A. U., Egbuche, F. G., Obi, O. J. and Chimezie, M. C. (2026). Ascaris lumbricoides infection (Ascariasis) exhibits varying prevalence but similar intensity across major socio-demographic groups in Aguleri, Anambra State, Nigeria. Helminthologia, 63(2): 87 - 98 . DOI 10.2478/helm-2026-0010
Gebru, H., Deyissia, N., Medhin, G. and Kloos, H. (2023). The Association of Sanitation and Hygiene Practices with Intestinal Parasitic Infections Among Under-14 Children in Rural Dire Dawa, Eastern Ethiopia: A Community-Based Cross-sectional Study. Environmental Health Insights. 23(17). doi:10.1177/11786302231180801
Gizaw, Z., Yalew, A. W. and Bitew, B. D. (2022). Faecal indicator bacteria along multiple environmental exposure pathways (water, food, and soil) and intestinal parasites among children in the rural northwest Ethiopia. BioMed Central Gastroenterology 22 (84). https://doi.org/10.1186/s12876-022-02174-4
Ikpeoha, B. C., Aribodor, D. N., Okwelogu, I. S., Okoye, C. M. and Anyanebechi, W. C. (2024). Soil-transmitted helminthiasis among pupils in Semi- Urban communities in Anambra State, Nigeria. South Asian Journal of Parasitology,7(2): 141-151)
National Population Commission (NPC) (2006). Nigerian National Census: Population Distribution by Sex, State, LGAs, and Senatorial District.
Njambi, E., Magu, D., Masaku, J., Okoyo, C. and Njenga, S. M. (2020). Prevalence of Intestinal Parasitic Infections and Associated Water, Sanitation, and Hygiene Risk Factors among School Children in Mwea Irrigation Scheme, Kirinyaga County, Kenya. Journal of Tropical Medicine, 3974156. https://doi.org/10.1155/2020/3974156
Nnelife, E. G., Imakwu, C. A., Ebere, C. S., Okeke, O. A. and Uzochukwu, C. U. (2026). Intestinal Parasitic infections among pregnant females in Anambra East LGA, Anambra State. South Asian Journal of Parasitology, 9(2): 220-231.
Nwankwo, A., Onyebueke, A. C., Irikannu, K. C., Nzeukwu, C. I., Onwuzulike, I. V. and Okafor, N. M. (2021). Soil-transmitted helminths infection and associated risk factors among primary school pupils in Omogho and Awa communities, Anambra State, Nigeria. International Journal of Tropical Disease and Health, 42(8): 56–64. https://doi.org/10.9734/IJTDH/2021/v42i830478
Nzeukwu, C.I., Irikannu, K.C., Ihejie, P.O., Umeaneto, P.U., Nzeukwu, A.C., Elosiuba, N.V., Onwuachusi, G.L., Obiefule, I.E. and Aniefuna, C.O. (2022). Prevalence and risk factors for soil-transmitted helminth infections among pupils in Awka South LGA, Anambra State, Nigeria: Short communication. The Bioscientist Journal, 10(2): 156-166. http://bioscientistjournal.com/index.php/The_Bioscientist/article/download/114/118
Ohuche, I. O., Ayuk, A. C., Ubesie, A. C., Onu, J. U. and Ibe, B.C . (2020). Soil-transmitted Helminthiasis: A Neglected Tropical Disease among Urban Slum Dwelling School-aged Children of a Sub-Saharan African City. Nigerian Postgraduate Medical Journal 27(3): 184-189. DOI: 10.4103/npmj.npmj_38_20
Okechukwu, P. C., Iwueze, M. O. and Uzochukwu, C.U. (2024). Status of intestinal helminth infections in pupils at Enugu, South East Nigeria. The Biomedical Diagnostics Journal, 8: 277-288. www.thebiomedicaldiagnostics.org
Okesanya, O. J., Eshun, G., Ukoaka, B. M., Manirambona, E., Olabode, O. N., Adesola, R. O., Okon, I. I., Jamil, S., Singh, A., Lucero‑Prisno III, D. E., Ali, H. M. and Chowdhury, A. B. M. A. (2024). Water, sanitation, and hygiene (WASH) practices in Africa: exploring the effects on public health and sustainable development plans. Tropical Medical and Health. 52: 68. https://doi.org/10.1186/s41182-024-00614-3
Orjighjigh, I. C., Ikeh, M. I., Okeke, O. A. and Godwin, B. A. (2024). Healthcare-associated intestinal protozoan parasites among inpatients of a tertiary healthcare facility in Awka, Anambra State, Nigeria. International Journal of Enteric Pathogens, 12(1), 15–20. https://doi.org/10.34172/ijep.5624
Oyebamiji, D. A. (2023). Environmental factors and cultural practices influencing the epidemiology of soil-transmitted helminths in Ibadan, Nigeria (Master’s thesis). University of Ibadan. http://hdl.handle.net/123456789/2159
Sitotaw, Baye, Shiferaw and Wakgari (2020). Prevalence of Intestinal Parasitic Infections and Associated Risk Factors among the First-Cycle Primary Schoolchildren in Sasiga District, Southwest Ethiopia, Journal of Parasitology Research, 8681247. https://doi.org/10.1155/2020/8681247
Umeanaeto, P. U., Okouzi, G. O., Ezeibe, M. O., Irikannu, K. C., Nzeukwu, C. I. and Obiefule, I. E. (2024). “Prevalence of Gastrointestinal Parasites among Secondary School Students in Nanka, Orumba North L.G.A, Anambra State”. South Asian Journal of Parasitology 7(3):217-24. https://journalsajp.com/index.php/SAJP/article/view/186
World Health Organization and UNICEF (2018). School WASH guidelines. Geneva: WHO. https://www.who.int/publications/m/item/drinking-water-sanitation-and-hygiene-in-schools-global-baseline-report-2018
World Health Organization. (2004). Training manual on diagnosis of intestinal parasites Geneva: World Health Organization. https://iris.who.int/bitstream/handle/10665/63790/WHO_CTD_SIP_98.2.pdf?sequence=1
World Health Organization. (2019). Safer water, better health: 2019 update. World Health Organization. ISBN: 978-92-4-151689-1. https://iris.who.int/bitstream/handle/10665/329905/9789241516891-eng.pdf
World Health Organization. (2023). WASH and health working together: A “how-to” guide for neglected tropical diseases. World Health Organization. https://doi org/10.24171/9789240068032
Ahmed, M. (2023). Intestinal Parasitic Infections in 2023. Gastroenterology Research, 16(3):127-140. doi: 10.14740/gr1622.
Ali, T., Sahar, G., Mahdi, J., Meysam, O., Amir, A. and Fatemeh, G. (2021). Global prevalence of intestinal parasitic infections and associated risk factors in pregnant women: a systematic review and meta-analysis, Transactions of The Royal Society of Tropical Medicine and Hygiene, 115(5), 457–470, https://doi.org/10.1093/trstmh/traa101
Alo, C., Akamike, I., Agbo, U., Eze, I., Madudueze, U., Okedo-Alex, I., Azuogu, B., Una, A., Elum, P., Ugochukwu, C., Nwonwu, E. and Ogbonnaya, L. (2021). Prevalence, Knowledge, Attitude and Preventive Practices Regarding Intestinal and Urinary Parasites among Primary School Children in a Rural Community in Ebonyi State, Nigeria. Journal of Epidemiological Society of Nigeria, 4(1), 39–50. https://doi.org/10.46912/jeson.39
Amisu, B. O., Okesanya, O. J., Olaleke, N. O., Ologun, C. O., Lucero-Prisno, D. E., Ogunwale, V. O., Ahuoyiza, R. A., Manirambona, E., Padhi, B. K. and Mewara, A. (2023). Socio-environmental determinants of parasitic intestinal infections among children: a cross-sectional study in Nigeria. Journal of Global Health Science, 5(1). https://doi.org/10.35500/jghs.2023.5.e6
Anthony, D., Biaton, D., Musa, A. D., Udofia, L. E. and Yakubu, E. D. (2022). A study on the gastrointestinal parasites (GIP) of wild animals found within the surrounding forests of Zuku and Rumfan Gwamna villages in Bassa Local Government Area, Plateau State, Nigeria. World Journal of Advanced Research and Reviews, 14(02), 384–392. https://doi.org/10.30574/wjarr.2022.14.2.0336
Aribodor, O. B., Jacob, E. C., Azugo, N. O., Ngenegbo, U. C., Obika, I., Obikwelu, E. M. and Nebe, O. J. (2025). Soil-transmitted helminthiasis among adolescents in Anaocha Local Government Area, Anambra State, Nigeria: Insights and recommendations for effective control. Public Library of Science ONE, 20(1), e0292146. https://doi.org/10.1371/journal.pone.0292146.
Atta, H. I., Isah, U., and Amadi, K. U. (2019). Prevalence of soil-transmitted helminths in children attending public primary schools in Samaru, Zaria, Nigeria. Federal University Wukari Trends in Science and Technology Journal, 4(1), 32–35. https://www.researchgate.net/profile/Habiba-Atta/publication/332844978
Bello, O. H. N., Odu, M. A., Okueso, S. A. and Kalesanwo, O. O. (2025). Assessment of usage of water, sanitation and hygiene facilities among public secondary school students in Ogun State. Journal of Humanities, Social Sciences and Creative Arts, 20, 80–86. https://journal.funaab.edu.ng/index.php/JHSSCA/article/view/2497
Cheesbrough, M. (2000, 2006). Parasitological tests. District Laboratory Practice in Tropical Countries; part 2. University Press, Cambridge, 239-258. https://scholar.archive.org/work/7ilsko6rbje5pg3bp7572pk7wq/access/wayback/http://isnra.com:80/ojs/index.php/M/article/download/47/14/
Chidozie, G. N., Egbuche, C. M., Amoke, C. O., Okeke, A. U., Egbuche, F. G., Obi, O. J., Chimezie, M. C., and Nwachukwu, C. A. (2025). ‘Irregular CDD’ and ‘Mosaic pattern of WASH’ activities towards ‘STH’ control: A case study of Aguleri, Anambra-East LGA, Anambra state, Nigeria. The Bioscientist, 13(2): 16 – 27.
Cochran, W.G. (1977). Sampling techniques (3rded). John Wiley and sons.
Egbuche, C. M., Chukwu, I., Ezihe, C. K., and Ngenegbo, U. C. (2017). Impact of Control Measures on the Prevalence of Intestinal Parasite Infections among Primary School Pupils. International Journal of Research in Pharmacy and Biosciences; 4(5): 1-5.
Egbuche, F. G., Iwueze, M. O., Egbuche, C. M., Anyasodor, A. E., and Amoke, O. C. (2024). Geohelminth Infections and Wash Practices among Primary School Pupils in Mgbakwu, Awka North LGA, Anambra State, Nigeria. The Bioscientist Journal, 12(1), 47-58. https://doi.org/10.54117/the_bioscientist.v12i1.165
Egbuche, C., Amoke, C., Okalu, U., Egbuche, F., Obiakor, U. and Chimezie, M. (2025). Status of School-Based Water, Sanitation, Hygiene (WASH) Resources and Soil Transmitted Helminth (STH) Infections in Rural Nigeria: A Pilot Study. Journal of Health and Environmental Research, 11(2): 38 – 47
Egbuche, C. M., Chidozie, G. N., Amoke, C. O., Okeke, A. U., Egbuche, F. G., Obi, O. J. and Chimezie, M. C. (2026). Ascaris lumbricoides infection (Ascariasis) exhibits varying prevalence but similar intensity across major socio-demographic groups in Aguleri, Anambra State, Nigeria. Helminthologia, 63(2): 87 - 98 . DOI 10.2478/helm-2026-0010
Gebru, H., Deyissia, N., Medhin, G. and Kloos, H. (2023). The Association of Sanitation and Hygiene Practices with Intestinal Parasitic Infections Among Under-14 Children in Rural Dire Dawa, Eastern Ethiopia: A Community-Based Cross-sectional Study. Environmental Health Insights. 23(17). doi:10.1177/11786302231180801
Gizaw, Z., Yalew, A. W. and Bitew, B. D. (2022). Faecal indicator bacteria along multiple environmental exposure pathways (water, food, and soil) and intestinal parasites among children in the rural northwest Ethiopia. BioMed Central Gastroenterology 22 (84). https://doi.org/10.1186/s12876-022-02174-4
Ikpeoha, B. C., Aribodor, D. N., Okwelogu, I. S., Okoye, C. M. and Anyanebechi, W. C. (2024). Soil-transmitted helminthiasis among pupils in Semi- Urban communities in Anambra State, Nigeria. South Asian Journal of Parasitology,7(2): 141-151)
National Population Commission (NPC) (2006). Nigerian National Census: Population Distribution by Sex, State, LGAs, and Senatorial District.
Njambi, E., Magu, D., Masaku, J., Okoyo, C. and Njenga, S. M. (2020). Prevalence of Intestinal Parasitic Infections and Associated Water, Sanitation, and Hygiene Risk Factors among School Children in Mwea Irrigation Scheme, Kirinyaga County, Kenya. Journal of Tropical Medicine, 3974156. https://doi.org/10.1155/2020/3974156
Nnelife, E. G., Imakwu, C. A., Ebere, C. S., Okeke, O. A. and Uzochukwu, C. U. (2026). Intestinal Parasitic infections among pregnant females in Anambra East LGA, Anambra State. South Asian Journal of Parasitology, 9(2): 220-231.
Nwankwo, A., Onyebueke, A. C., Irikannu, K. C., Nzeukwu, C. I., Onwuzulike, I. V. and Okafor, N. M. (2021). Soil-transmitted helminths infection and associated risk factors among primary school pupils in Omogho and Awa communities, Anambra State, Nigeria. International Journal of Tropical Disease and Health, 42(8): 56–64. https://doi.org/10.9734/IJTDH/2021/v42i830478
Nzeukwu, C.I., Irikannu, K.C., Ihejie, P.O., Umeaneto, P.U., Nzeukwu, A.C., Elosiuba, N.V., Onwuachusi, G.L., Obiefule, I.E. and Aniefuna, C.O. (2022). Prevalence and risk factors for soil-transmitted helminth infections among pupils in Awka South LGA, Anambra State, Nigeria: Short communication. The Bioscientist Journal, 10(2): 156-166. http://bioscientistjournal.com/index.php/The_Bioscientist/article/download/114/118
Ohuche, I. O., Ayuk, A. C., Ubesie, A. C., Onu, J. U. and Ibe, B.C . (2020). Soil-transmitted Helminthiasis: A Neglected Tropical Disease among Urban Slum Dwelling School-aged Children of a Sub-Saharan African City. Nigerian Postgraduate Medical Journal 27(3): 184-189. DOI: 10.4103/npmj.npmj_38_20
Okechukwu, P. C., Iwueze, M. O. and Uzochukwu, C.U. (2024). Status of intestinal helminth infections in pupils at Enugu, South East Nigeria. The Biomedical Diagnostics Journal, 8: 277-288. www.thebiomedicaldiagnostics.org
Okesanya, O. J., Eshun, G., Ukoaka, B. M., Manirambona, E., Olabode, O. N., Adesola, R. O., Okon, I. I., Jamil, S., Singh, A., Lucero‑Prisno III, D. E., Ali, H. M. and Chowdhury, A. B. M. A. (2024). Water, sanitation, and hygiene (WASH) practices in Africa: exploring the effects on public health and sustainable development plans. Tropical Medical and Health. 52: 68. https://doi.org/10.1186/s41182-024-00614-3
Orjighjigh, I. C., Ikeh, M. I., Okeke, O. A. and Godwin, B. A. (2024). Healthcare-associated intestinal protozoan parasites among inpatients of a tertiary healthcare facility in Awka, Anambra State, Nigeria. International Journal of Enteric Pathogens, 12(1), 15–20. https://doi.org/10.34172/ijep.5624
Oyebamiji, D. A. (2023). Environmental factors and cultural practices influencing the epidemiology of soil-transmitted helminths in Ibadan, Nigeria (Master’s thesis). University of Ibadan. http://hdl.handle.net/123456789/2159
Sitotaw, Baye, Shiferaw and Wakgari (2020). Prevalence of Intestinal Parasitic Infections and Associated Risk Factors among the First-Cycle Primary Schoolchildren in Sasiga District, Southwest Ethiopia, Journal of Parasitology Research, 8681247. https://doi.org/10.1155/2020/8681247
Umeanaeto, P. U., Okouzi, G. O., Ezeibe, M. O., Irikannu, K. C., Nzeukwu, C. I. and Obiefule, I. E. (2024). “Prevalence of Gastrointestinal Parasites among Secondary School Students in Nanka, Orumba North L.G.A, Anambra State”. South Asian Journal of Parasitology 7(3):217-24. https://journalsajp.com/index.php/SAJP/article/view/186
World Health Organization and UNICEF (2018). School WASH guidelines. Geneva: WHO. https://www.who.int/publications/m/item/drinking-water-sanitation-and-hygiene-in-schools-global-baseline-report-2018
World Health Organization. (2004). Training manual on diagnosis of intestinal parasites Geneva: World Health Organization. https://iris.who.int/bitstream/handle/10665/63790/WHO_CTD_SIP_98.2.pdf?sequence=1
World Health Organization. (2019). Safer water, better health: 2019 update. World Health Organization. ISBN: 978-92-4-151689-1. https://iris.who.int/bitstream/handle/10665/329905/9789241516891-eng.pdf
World Health Organization. (2023). WASH and health working together: A “how-to” guide for neglected tropical diseases. World Health Organization. https://doi org/10.24171/9789240068032