Soil-transmitted helminth infections, associated factors and nutritional status in an estate community in Sri Lanka

Objectives: To determine the prevalence, intensity, and risk factors associated with soil transmitted helminth (STH) infections and to explore the association between STH infections and nutritional status of an estate community.

Methods: A cross-sectional study was conducted in Hanthana Tea Estate (HTE) in Kandy, Sri Lanka, from September 2013 to November 2014. Demographic data were obtained using an interviewer-administrated structured questionnaire. Haemoglobin and serum albumin concentrations were measured in children. Faecal samples were analyzed by direct smears in saline and iodine and Kato-Katz technique using single-stool samples. Anthropometric measurements were obtained to calculate weight-for-age (WAZ), height-for-age (HAZ), and body-mass-index-for-age (BAZ) to evaluate underweight, stunting and wasting, respectively.

Results: A total of 233 children (50% female, aged between 1 and 12 years, mean age 6.2±3.4) and 98 parents (93% female, aged between 20 and 52 years, mean age 33±6.2 years) participated in this study. The prevalence of STH infections in children and adults were 27.4% and 14.3% respectively. Ascaris lumbricoides was found in children and adult populations predominantly (26.6% and 14.3% respectively) followed by Trichuris trichiura (0.8% and 1%).

Of the infected group, 57.8% of children and 92.8% of adults had a light infection. Moderate infection was found in 40.6% of the children, and 7.2% of the adults. Only one child had a heavy egg count (≥ 50000). The prevalence of STH infections was significantly higher among children than adults (p = 0.014). Not hand washing before a meal (p = 0.002) and after defecation (p < 0.001), greater de-worming period (p < 0.001), use of shared latrine facilities (p = 0.023) and lower levels of mother`s education (p= 0.035) were significantly associated with STH infections. Children with and without STH infection had comparable levels of nutritional indicators. However, 17.6% (n=41) of stunted, 19.3% (n=45) of wasted and 39.5% (n=92) of underweight children were identified in the present study. In addition, 20.2% (n=47) of the children had a low serum albumin level and 15.9% (n=27) had anaemia.

Conclusions: Prevalence of STH infections was notably high in both children (27.4%) and their parents (14.3%), indicating a high level of morbidity among the study population. Therefore, a coordinated control and prevention programme considering the diverse socio-demographic characteristics of estate communities is needed to eliminate STH infections in the study population.