School children bear a significant burden of intestinal parasitic infections. Because they spend most of their time at home and school, it is necessary to identify the key water, sanitation, and hygiene (WASH) factors associated with these infections in both environments. This was a cross-sectional survey conducted in Mwea West, Kirinyaga County. 180 primary school children aged 8–14 years were randomly selected from three schools (Mianya, Mbui Njeru, and Mukou primary schools). Questionnaires and checklists were administered and single stool samples were collected. Stool samples were microscopically examined for Schistosoma mansoni, soil-transmitted helminths, and protozoan infections. Data on WASH were obtained at home and school. The factors significantly associated with S. mansoni and intestinal protozoa infections in the school children were determined using univariable and multivariable logistic regression models reporting the odds ratio at 95% confidence intervals. The overall prevalence of S. mansoni and intestinal protozoa infections was 70.5% (95% CI: 59.1–84.3) and 32.7% (95% CI: 26.8–40.1), respectively. Only one case of STH (A. lumbricoides) was identified. The prevalence of coinfections of S. mansoni and intestinal protozoa infections was 22.8% (95% CI: 19.2–27.1). An increased prevalence of S. mansoni infection was associated with children above 12 years (aOR = 3.19, p=0.015), those in Mianya primary (aOR = 1.23, p=0.001), those in Mukou primary (aOR = 3.19, p=0.001), and reported behavior of wearing shoes at home (aOR = 1.67, p=0.010). However, handwashing behavior after defecation at home (aOR = 0.39, p=0.001) was protective against S. mansoni infection. For any protozoan infection, male children had increased odds of infection (aOR = 2.41, p=0.001) while use of wiping material (aOR = 0.55, p=0.019) and water contact (aOR = 0.32, p=0.001) was protective against intestinal protozoa infections. Infections with S. mansoni and any protozoa and their coinfection were present. Findings revealed that several hygiene factors were protective against infections while other were risk factors. Therefore, deworming should be complemented with behavior education on hygienic habits.

Background Soil-transmitted helminthiasis (STH) continue to be a significant health problem in Sub-Saharan Africa especially among school children. In Kenya, treatment of over five million children has been conducted annually in 28 endemic counties since the year 2012. However, the latest monitoring and evaluation (M&E) results indicated a slow decline of prevalence and intensity of STH in some counties after the seven rounds of annual mass drug administration (MDA). The current study sought to determine the factors associated with the slow decline in prevalence and intensity of STH among school children participating in the school deworming programme. Methodology Mixed methods cross-sectional study was conducted in three endemic counties of Kenya. For quantitative technique, simple random sampling was used to select 1,874 school children from six purposively selected primary schools. The school children were interviewed, and a single stool collected and analysed using Kato-Katz technique. While for qualitative methods, 15 focus group discussions (FGDs) were conducted with purposively selected parents/guardians of school children. Data was collected through voice records using FGD and analyzed using NVIVO. Findings Prevalence of any STH infection was 30.8% (95%CI: 28.7–32.9), with the highest prevalence observed in Vihiga County (40.7%; 95%CI: 37.4–44.4). Multivariable analysis revealed that geographical location (OR = 3.78, (95%CI: 1.81–7.88) p<0.001), and not washing hands after defecation (OR = 1.91, (95%CI: 1.13–3.20) p = 0.015) were significantly associated with any STH infection. For qualitative analysis, majority of the parents/guardians of SAC felt that poor water sanitation and hygiene practices (WASH) both in school and household level could be a cause of continued STH infection. Also failing to include the rest of the community members in the MDAs were mentioned as possible contributors to observed slow decline of STH. Conclusions There was moderate STH prevalence and mean intensity despite the seven rounds of repeated annual MDA. The study recommends a revamped awareness creation on WASH and community wide treatment.