A holistic approach is needed to control the perpetual burden of soil-transmitted helminth infections among indigenous schoolchildren in Malaysia

ABSTRACT

A cross-sectional survey was conducted among 1,142 Orang Ali schoolchildren in six states of Peninsular Malaysia to investigate the current prevalence and risk factors of STH infections. Faecal samples were examined using direct smear, formalin-ether sedimentation, Kato–Katz, and Harada–Mori methods. A pre-tested questionnaire was used to collect information on the demographic, socioeconomic, personal hygiene, and health status of the participants. Overall, 70.1% (95% CI = 67.4, 72.7) of the participants were infected with at least one of the STH species. The prevalence of Ascaris lumbricoides, Trichuris trichiura, and hookworm infections was 63.1%, 61.8% and 11.5%, respectively. Moderate-to-heavy STH infections accounted for 61.3% of the total infections. Univariate and logistic regression analyses revealed different sets of risk factors, with age (> 10 years) being the significant risk factor of all three STH species. Moreover, other species-specific risk factors were identified including being a member of the Senoi tribe, family size (≥ 7 members), school size (150–250 pupils), maternal unemployment, unimproved source of drinking water, lacking improved toilet in the house, inadequate WASH facilities at school, not washing hands before eating, and not washing fruits before eating; presence of domestic animals, and not wearing shoes when outside. The high prevalence of STH infections found in the study population exceeds the WHO policy intervention threshold (20% prevalence). Thus, an innovative holistic approach should be adopted to control STH infections among these children as part of the efforts to improve the quality of life of the entire Orang Asli population. .

KEYWORDS:

• Soil-transmitted helminth
• neglected tropical diseases
• infectious diseases
• indigenous
• Orang Asli
• schoolchildren
• Malaysia

Acknowledgements

We would like to thank the Department of Orang Asli Development (JAKOA), Ministry of Rural and Regional Development, Kuala Lumpur, Malaysiafor their generous cooperation and support during the study. We are also thankful to the Departments of Education in the targeted states for their fruitful cooperation. Special thanks also go to the schools’ headmasters, teachers and administrative staff for their support and cooperation. We would like to express our thankfulness to the schoolchildren and their parents/guardians for their voluntary involvement in this study.

Disclosure statement

The authors report no declaration of interest.

Additional information

Funding

This work was supported by the Universiti Malaya [H-20001-00-E00051].