Soil-transmitted helminthiases are a public health problem in rural communities. A cross-sectional study of the prevalence and distribution of Ascaris lumbricoides, Trichuris trichiura and hookworm was conducted in 281 Orang Asli children (aborigines) aged between 2 and 15 years, from 8 Orang Asli villages in Selangor, Malaysia. All the children were infected with soil-transmitted helminthes, with 26.3% of the children infected either with A. lumbricoides, T. trichiura or hookworm and 72.6% having mixed infection. The overall prevalences of A. lumbricoides, T. trichiura and hookworm were 61.9, 98.2 and 37.0%, respectively. Approximately 19.0, 26.0 and 3.0% of the children had severe infection of ascariasis, trichuriasis and hookworm infection, respectively. The prevalences and mean egg per gram (epg) counts for A. lumbricoides and T. trichiura were not significantly dependent on age, therefore age-dependent convexity was not seen in this study. However, the results of this study reveal an age-dependent prevalence and mean epg count in children with hookworm infection. We conclude that ascariasis, trichuriasis and hookworm infection are still prevalent and therefore a public health concern in Orang Asli communities. Severe ascariasis and trichuriasis may lead to other health and medical problems.
A total of 819 Indian inhabitants (from 6 months to over 60 years of age) in an oil-palm plantation in West Malaysia was examined for soil-transmitted helminthiases using the brine flotation and Kato thick smear techniques. Half (51.0%) of the inhabitants were found to be infected (33.9% had Ascaris lumbricoides; 36.4% had Trichuris trichiura and 15.6% had Necator americanus). Soil-transmitted helminthiases (both single and mixed infections) were significantly more common among children and young adults from 6 months to 20 years of age where 67.1% (range: 64.7-70.3%) of this age group were infected. The infection rate declined to about 25% or less among elderly people over 50 years of age. Trichuris trichiura was the commonest helminth observed--both as single and mixed infections--and Trichuris mixed with Ascaris was the commonest type of double infection reported. However, there were no significant differences in the distribution of the types of single and double infections among inhabitants of different age groups, nor were there any significant differences in the distribution of soil-transmitted helminthiases among male and female inhabitants. The socioeconomic, environmental and cultural factors contributing to persistently high rates of infection with soil-transmitted helminths among plantation inhabitants are discussed.
The efficacy of a single-dose 400 mg albendazole to treat Ascaris, Trichuris and hookworm infection was studied in Orang Asli community. Kato-Katz examination was performed on fecal samples which were collected before treatment, 1 and 4 months after treatment. A total of 123 children were involved in all three surveys. The cure rate of Ascaris infection was 97.4% and the egg reduction after treatment was 99.9%. The cure rate for hookworm infection was 93.1% with 96.6% egg reduction. Although the cure rate was low in Trichuris infection (5.5%), egg reduction was more evident (49.1%). The reinfection rate at 4 months after treatment was 54.5%, 3.6% and 10.3% for Ascaris, Trichuris and hookworm infection, respectively. Within 4 months after treatment almost one-fifth children with Ascaris and hookworm infection reached pre-treatment intensity infection. In Trichuris infection, however more than half of the children reached their pre-treatment intensity infection at 4 months after treatment. Findings suggest that 4-monthly targeted periodic treatment with 400 mg single-dose albendazole in highly endemic areas can have a significant impact on intensity infection of Ascaris and hookworm, but not on Trichuris infection.
Data on soil-transmitted helminth (STH) infections and reinfection among Orang Asli (aborigine) schoolchildren and their nutritional and socioeconomic status were analyzed to investigate the pattern and the possible predictors of STH reinfection. In this longitudinal study, 120 (60 males and 60 females) Orang Asli primary schoolchildren aged 7-12 years and living in remote areas in Pos Betau, Kuala Lipis, Pahang were screened for the presence of STH using modified cellophane thick smear and Harada Mori techniques. The overall prevalence of ascariasis, trichuriasis and hookworm infections were 65.8, 97.5 and 10.8%, respectively. After complete deworming with a 3-day course of 400mg/daily of albendazole tablets, children were re-examined at 3 and 6 months from baseline. The reinfection rate, by one or more of STH species, at 3 months after deworming was high (49.5%) while 79.6% of the children were reinfected at 6 months after deworming. Logistic regression analyses showed that females, stunted children and those living in houses without toilets had significantly higher reinfection rates than others at 3 months (P<0.05). At 6 months, maternal employment status emerged as another predictor where children of working mothers had significantly higher reinfection rates (P=0.026). In conclusion, reinfection rate of STH is high and thus necessitates frequent and periodic deworming among children. Public health personnel need to re-look at the current control measures and identify innovative and integrated ways in order to reduce STH significantly in the rural communities.
Soil-transmitted helminthiasis (STH), among the most common neglected tropical diseases, is a major public health problem in Malaysia with a possible impact on the nutritional status and school participation of rural children. This study was carried out among Aboriginal schoolchildren, living in an endemic area for STH in Malaysia, to determine the possible relationship between intestinal helminthiasis and school absenteeism. We also evaluated whether successful treatment of the infection will affect school attendance among the subjects. Stool analysis revealed that more than 90% of the subjects were infected with at least 1 helminth species, with Ascaris lumbricoides and Trichuris trichiura infections being most prevalent. Infection of moderate-to-heavy worm burdens, low level of fathers' education and anaemia were identified as the significant predictors of high absenteeism among the subjects (P<0·05). Following treatment of the infected children, it was found that school absenteeism was reduced significantly (P<0·01). In conclusion, STH continues to have significant impacts on public health, particularly in rural communities with a negatively significant effect on the school participation of Aboriginal children. A school-based de-worming programme should be introduced and incorporated in the current educational assistance targeted towards the Aboriginal communities, under the auspices of the government.