Abstract :

Background: Soil-Transmitted Helminth (STH) infections remain a public health concern in tropical regions, particularly among school-aged children, while local data and risk mapping in the service area of Nulle Primary Health Center are limited.

Objective: To estimate the prevalence of STH infection, identify water, sanitation, and hygiene (WASH)–related risk factors, and spatially map infection clusters among primary schoolchildren in South Central Timor, Indonesia.

Methods: A cross-sectional survey was conducted in seven primary schools from 10–16 June 2025, involving 263 students. Data on WASH-related behaviors and environmental conditions were collected using structured questionnaires. Stool samples were examined using the direct smear method with 2% eosin and 2% lugol’s iodine. Bivariate analysis was performed using Fisher’s exact test with α = 0.05. Geographic household coordinates of STH-positive cases were mapped using ArcGIS to identify spatial clusters.

Results: The prevalence of helminth infection was 4.6% (12/263). The most common species identified was Ascaris lumbricoides (83.3%), followed by Trichuris trichiura and mixed infections (each 8.3%). Handwashing habits, nail trimming, consumption of raw food, use of footwear, latrine ownership, and household water source were significantly associated with infection (p<0.05). GIS mapping revealed high-risk areas in Nulle, Tublopo, and Benlutu villages, characterized by high soil humidity, suitable temperature and soil type, as well as poor sanitation conditions.

Conclusion: STH infection in the Nulle area remains a concern, influenced by hygiene behaviors and environmental conditions. Location-based promotive and preventive efforts are essential to reduce infection rates.

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Keywords :

GIS, Risk factors., schoolchildren, Soil-transmitted helminths, WASH

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References :

1. World Health Organization (WHO). Soil-transmitted helminthiases. 2023. Available from: https://apps.who.int/neglected_diseases/ntddata/sth/sth.html
2. Feleke BE, Beyene MB, Feleke TE, Jember TH, Abera B. Intestinal parasitic infection among household contacts of primary cases: a comparative cross-sectional study. PLoS One. 2019;14(10).
3. Ministry of Health of the Republic of Indonesia. Several Tropical Diseases That Must Be Watched Out For. 2023.
4. Bhadi Bia M, Susilawati NM, Rantesalu A, Octrisdey K, Rohi Bire WLO. Personal hygiene and incidence of Soil-Transmitted Helminths among elementary school students in Amanuban Barat District, South Central Timor. Jurnal Info Kesehatan. 2022;20(2):260–9.
5. Gebreyesus TD, Makonnen E, Tadele T, Mekete K, Gashaw H, Gerba H, et al. Reduced efficacy of single-dose albendazole against Ascaris lumbricoides and Trichuris trichiura, and high reinfection rate among school children in Southern Ethiopia: a prospective cohort study. Infect Dis Poverty. 2024;13(1).
6. Strunz EC, Addiss DG, Stocks ME, Ogden S, Utzinger J, Freeman MC. Water, sanitation, hygiene, and soil-transmitted helminth infection: a systematic review and meta-analysis. PLoS Med. 2014;11(3).
7. Garn JV, Sclar GD, Freeman MC, Penakalapati G, Alexander KT, Brooks P, et al. The impact of sanitation interventions on latrine coverage and latrine use: a systematic review and meta-analysis. Int J Hyg Environ Health. 2017;220:329–40.
8. Sidik MM. Early Warning Mapping for Dengue Fever Occurrence in South Tangerang City in 2016–2018. 2020.
9. Amalia YN, Sari OP, Munfiah S. The relationship between helminth infection and nutritional status among elementary school students. Jurnal Pendidikan dan Teknologi Indonesia. 2021;1(2):81–9.
10. Curico G, Garcia Bardales PF, Pinedo Vasquez TN, Lopez WVS, Olortegui MP, Schiaffino F, et al. Efficacy of single-dose albendazole and albendazole plus ivermectin for soil-transmitted helminth infection in children in the Peruvian Amazon. Am J Trop Med Hyg. 2024;111(1):80–8.
11. Wulandari RD, Pertiwi EW. Knowledge and role of parents toward clean and healthy living behavior among primary school students in Kramatwatu, Serang. J Dunia Kesmas. 2018;7(4):225–31. Available from: https://ejurnalmalahayati.ac.id/index.php/duniakesmas/article/viewFile/1091/pdf
12. Malino MGO. Analysis of Water Quality in Nulle Village, Amanuban Barat District, South Central Timor Regency. ejurnalUndana. 2021;14.
13. Trasia RF. Epidemiological review: mapping cases and prevalence of helminthiasis in Indonesia in 2020–2022. International Islamic Medical Journal. 2023;4(2):37–50.
14. Ministry of Health of the Republic of Indonesia. Regulation of the Minister of Health of the Republic of Indonesia No. 15 of 2017 concerning Helminth Control. Jakarta; 2017.