Effect of uptake and effectiveness of different WASH modalities on the probability of elimination of hookworm infection after five years of community-wide PCT.

Rows of panels represent settings with different pre-control hookworm infection prevalence in the general population. For all three settings, we simulated five years of either annual (red lines) or semi-annual (green lines) community-wide PCT with ALB, implemented at 90% coverage. After five years, PCT is stopped and one of three types of WASH interventions (columns) is simulated, which reduce participating individuals’ contribution (sanitation) and/or exposure (hygiene) to the environmental reservoir of infection by 70% or 95% (effectiveness), represented by solid and dashed lines, respectively. Uptake of WASH interventions (x-axis) is defined as the (random) proportion of people who take up the intervention. Uptake of sanitation and hygiene measures in the combined WASH intervention (third column) is assumed to be perfectly correlated within individuals. Elimination is defined as absence of any worms 50 years after stopping PCT in the simulated population of about 400 individuals.