The burden of moderate-to-heavy soil-transmitted helminth infections among rural malaysian aborigines: an urgent need for an integrated control programme

Abstract

BackgroundSoil-transmitted helminth (STH) infections, among the most common neglected tropical diseases, continue to be a major threat to the health and socioeconomic wellbeing of infected people especially children in developing countries.MethodsA cross-sectional study among 254 aboriginal schoolchildren was conducted in order to determine the current prevalence and intensity of infections and to investigate the potential risk factors associated with moderate-to-heavy burden of STH infections among these children.ResultsOverall, 93.7% of children were found to be infected with one or more STH species. The prevalence of trichuriasis, ascariasis and hookworm infections were 84.6%, 47.6% and 3.9%, respectively. Almost half of the participants had heavy trichuriasis, one-quarter had heavy ascariasis whereas all hookworm infections were light infections. Overall, moderate-to-heavy STH infections accounted for 56.7% of the total infections. Univariate analysis revealed that those using untreated water supply (P = 0.013), living in houses without toilets (P = 0.027) and having domestic animals in the houses (P = 0.044) had significantly higher prevalence of moderate-to-heavy infections than others. Logistic regression analysis confirmed using untreated water for drinking (P = 0.001) and the absence of a toilet in the house (P = 0.003) as significant risk factors of moderate-to-heavy STH infections among these children.ConclusionThe high proportion of moderate-to-heavy STH infections further confirms the need for serious attention towards these devastating diseases that has put lives and the future of aboriginal children in jeopardy. Introduction of more poverty alleviation schemes, proper sanitation, provision of clean and safe drinking water, health education, as well as the introduction of periodic school-based deworming programmes are imperative among these communities in order to curtail the transmission and morbidity caused by STH.

Patterns and Risk Factors of Soil-Transmitted Helminthiasis Among Orang Asli Subgroups in Peninsular Malaysia

“…These findings were consistent with other local studies conducted among the Orang Asli communities where T. trichiura infection had the highest prevalence (range: 26% to 98.2%), followed by A. lumbricoides infection (range: 19% to 67.8%) and hookworm infection (range: 3% to 37%). [5][6][7][8][9] Hence, the findings in this study not only show that the prevalence of STH remains high but the distribution pattern of STH also remains unchanged among the Orang †Variables were confirmed by multiple logistic regression analysis as significant predictors of STH.…”

“…Likewise, several studies conducted in recent years reported a high prevalence of STH infections, which ranges from 90% and up to 100% among Orang Asli communities. [5][6][7][8][9] Of the three STH species, T. trichiura infection was the most predominant, followed by A. lumbricoides infection and hookworm infection. These findings were consistent with other local studies conducted among the Orang Asli communities where T. trichiura infection had the highest prevalence (range: 26% to 98.2%), followed by A. lumbricoides infection (range: 19% to 67.8%) and hookworm infection (range: 3% to 37%).…”

“…Similar findings have also been reported that non-working parents and low household income are significant predictors for acquiring STH infections among Orang Asli communities. [5][6][7][8][9] The effect of SES on risk of parasitic diseases in general and STH infections in particular, is complex in nature and could be attributed to several other factors such as lack of access to a clean water supply, poor personal and sanitary hygiene, inadequate basic infrastructure, low level of education attainment caused by financial constraints, overcrowding, and impoverished health services. 22,27 In such conditions, STH species are commonly co-endemic.…”

“…Several studies had been conducted in these communities between 2010 and 2013 reporting an overall prevalence of more than 50%, ranging from 52.4% to 92.2%. [7][8][9] With the exception of a study carried out by Dunn,13 almost all of these studies failed to take into consideration the differences in the respective Orang Asli subgroups. This is regrettable because Orang Asli is not a homogenous group as they are divided into various subgroups with different socio-demographic background.…”

“…Nevertheless, the country is still plagued with many parasitic diseases notably the perpetual STH infections, especially among poor and socioeconomically deprived communities, particularly the Orang Asli communities. [5][6][7][8][9] The "Orang Asli" translated as "original people" or "first people" are the indigenous minority people of Peninsular Malaysia. According to the latest available records, their population is 149,723, contributing to 0.7% of the total population in Malaysia.…”