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**Chapter 3**

**Abstract**

Helminths

ing disease transmission.

**1. Introduction**

Natural Wastewater Treatment

*Abdallah Zacharia, Anne H. Outwater and Rob Van Deun*

Wastewater reuse has been considered as an alternative way of overcoming water scarcity in many parts of the world. However, exposures to wastewater are associated with higher prevalence of soil-transmitted helminths (STHs). Globally, about two billion people are infected with at least one species of STHs with those having heavy infections presenting considerable morbidities. The most serious STH species infecting humans include roundworm (*Ascaris lumbricoides*), whipworm (*Trichuris trichiura*), and hookworms (*Necator americanus* and *Ancylostoma duodenale*). Despite ongoing control campaigns using preventive chemotherapy, wastewater in endemic countries still contains concentrations of STH eggs that put exposed populations at risk of infection. According to the World Health Organization, we can achieve sustainable control of STH by using improved sanitation systems. Since natural wastewater treatment systems (waste stabilization ponds and constructed wetlands) require low maintenance and operational costs, have low mechanical technology and energy consumption, they are ideal for sustainable sanitation services. In addition, natural wastewater treatment systems are reported to efficiently remove various pathogenic organisms from wastewater. This chapter explains the role of natural wastewater treatment systems as sustainable sanitation facilities in removing STH from wastewater and therefore prevent-

**Keywords:** *Ascaris lumbricoides*, constructed wetlands, hookworms, soil-transmitted

Population growth significantly contributes to water shortages in about 100 countries worldwide. It is estimated that by the year 2025, two-thirds of all people will be experiencing moderate to severe fresh water shortage [1]. Wastewater reuse has been considered as an alternative way of overcoming water scarcity in various parts of the world [2]. Treated and untreated wastewaters have been applied to economic and domestic activities including industry (applied in cooling and cleaning); recreation (swimming pools, irrigation of parks, and golf courses); and agriculture (irrigation) [3]. Globally more than 20 million hectares of agricultural

helminths, *Trichuris trichiura*, wastewater reuse, waste stabilization ponds

Systems for Prevention and

Control of Soil-Transmitted
