Peer-reviewed article
Malnutrition among children under 7 years of age linked to ascariasis: evidence from West Sumba, Indonesia, despite ongoing deworming program.
Kusumasari RA, Adi H, Satoto TBT, Wahab A, Murhandarwati EEH ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined soil-transmitted helminth infections and malnutrition in children under 7 years in West Sumba, Indonesia, where a deworming program has been in place since 2017. Researchers found that 32.5% of sampled children had helminth infections, with Ascaris lumbricoides strongly linked to stunting and malnutrition. Risk factors for infection included older age, lower parental education, poverty, poor sanitation practices, and lack of proper toilet facilities. The findings highlight a persistent public health gap in this low-resource tropical setting despite the existing deworming program.
Key points
- 32.5% prevalence of soil-transmitted helminth infection in children under 7 years (144 of 443 children)
- Ascaris lumbricoides infection was strongly associated with stunting and severe malnutrition (OR: 3.45, 95% CI: 1.70-7.02)
- Children aged over 2 years were 5.9 times more likely to have STH infection
- Risk factors included low parental education (OR: 4.1 for no education), poverty (OR: 5.6 for income <2.5 million rupiahs), poor sanitation, and ground-based play
- Kota Waikabubak sub-district had the highest burden of infection with stunting rates ranging from 5% to 37%
Limitations
This is a cross-sectional study conducted at a single point in time, so causality cannot be definitively established between helminth infection and malnutrition. The study does not evaluate the effectiveness of the deworming program itself or compare dewormed versus non-dewormed children.
Abstract
Background Soil-transmitted helminth (STH) diseases persist in various Asian nations, including Indonesia. The West Sumba District, located in East Nusa Tenggara Province, Indonesia, has been implementing a deworming program targeting children under 7 years of age since 2017. This study aims to assess the prevalence, intensity, and distribution of soil-transmitted helminthiasis and its association with nutritional status among children under 7 years of age in West Sumba District. Methods In this community-based cross-sectional study, children under 7 years of age registered at integrated health posts in eight primary health facilities in West Sumba District were randomly sampled (443 subjects) from October 2022 to January 2023. Kato-Katz methods were applied to detect STH infections. Malnutrition was determined using a Height-for-Age table with a Z-score (HAZ). Results The prevalence of STH in children under 7 years of age was 32.5% (144/443). Kota Waikabubak sub-district had the highest STH cases, with Trichuris trichiura (34.0%; 49/144)) and Ascaris lumbricoides (27.8%; 40/144) being the two common species. The following variables have been significant risk factors for STH infection: children aged > 2 years (OR: 5.9, 95% CI: 3.64-9.55, p < 0.001), parents with basic (OR: 1.8, 95% CI: 1.07-2.73, p < 0.001) and no educational level (OR: 4.1, 95% CI: 2.30-7.03, p < 0.001), family with monthly income < 2.5 million rupiahs (OR: 5.6, 95% CI: 1.70-18.78, p < 0.001), a preference for ground-based play (OR: 5.2, 95% CI: 2.65-10.04, p < 0.001), the presence of a private toilet at home (OR: 3.4, 95% CI: 2.22-5.19, p < 0.001), and have no septic tank for final disposal of stool (OR: 3.3, 95% CI: 1.91-5.75, p < 0.001). Malnutrition, indicated by stunted and severely stunted children with a range of cases from 5% to 37%, was strongly linked with A. lumbricoides infection (OR: 3.45, 95% CI: 1.70-7.02, p < 0.001) occurring in Kota Waikabubak and supported by spatial map analysis. Conclusions Current research indicates a notable link between STH infection, i.e. ascariasis, and stunting as a malnutrition status in children under 7 years of age in Kota Waikabubak, a densely populated capital city in the district's centre. This finding addresses a key public health gap by providing evidence on the early burden of helminthiasis in low-resource tropical settings.