Abstract :

Background: Soil-transmitted helminth (STH) infections remain a neglected public health problem in tropical regions, particularly in areas with poor sanitation and hygiene. These infections predominantly affect school-aged children and may contribute to impaired nutritional status. The working area of the Nulle Public Health Center is located in South Central Timor Regency, an area known to have a high prevalence of chronic malnutrition, highlighting the need to evaluate factors associated with nutritional problems.

Objective: To determine the prevalence of worm infection, nutritional status, and the association between worm infection and nutritional status among elementary school students in the working area of the Nulle Public Health Center.

Methods: This study employed a descriptive-analytic design with a cross-sectional approach. A total of 263 elementary school students were selected using cluster random sampling. Data collection included a risk-factor questionnaire, microscopic stool examination using 1% Lugol solution and eosin, and anthropometric assessment for nutritional status. Data were analyzed using univariate and bivariate methods. Fisher’s exact test was applied with a significance level of p<0.05.

Results: The prevalence of worm infection was 4.6% (12 out of 263 students). The most common helminth species identified was Ascaris lumbricoides (83.3%), followed by Trichuris trichiura and mixed infections (8.3% each). Nutritional status was predominantly normal (61.6%), followed by undernutrition (21.3%), severe malnutrition (13.3%), and overnutrition (3.8%). Among students with positive worm infection, the majority were classified as severely malnourished. Statistical analysis demonstrated a significant association between worm infection and nutritional status (p<0.05).

Conclusion: There is a significant relationship between worm infection and nutritional status among elementary school students in the working area of the Nulle Public Health Center.

---

Keywords :

elementary school students, Nutritional Status, Soil-transmitted helminths, Worm infection

---

References :

1. World Health Organization. Soil-transmitted helminth infections. Geneva: WHO; 2023.
2. World Health Organization. Neglected tropical diseases: progress report 2021–2022. Geneva: WHO; 2023.
3. Jourdan PM, Lamberton PHL, Fenwick A, Addiss DG. Soil-transmitted helminth infections. Lancet. 2018;391(10117):252–265.
   (classic reference; still cited in WHO and recent reviews)
4. Pullan RL, Smith JL, Jasrasaria R, Brooker SJ. Global numbers of infection and disease burden of soil transmitted helminth infections. Parasit Vectors. 2020;13:37.
5. Campbell SJ, Nery SV, Wardell R, et al. The global distribution of soil-transmitted helminth infections. PLoS Negl Trop Dis. 2020;14(4):e0007992.
6. Moser W, Schindler C, Keiser J. Efficacy of preventive chemotherapy against soil-transmitted helminth infections. Infect Dis Poverty. 2021;10:74.
7. World Health Organization. Deworming in children: eLENA guidelines. Geneva: WHO; 2023.
8. Stephenson LS, Latham MC, Ottesen EA. Malnutrition and parasitic helminth infections. Am J Clin Nutr. 2020;72(2):558–564.
   (classic nutritional–parasitology reference)
9. Hall A, Hewitt G, Tuffrey V, de Silva N. A review and meta-analysis of the impact of intestinal worms on child growth and nutrition. Parasitology. 2020;147(1):1–13.
10. Hotez PJ, Bundy DAP, Beegle K, et al. Helminth infections: soil-transmitted helminth infections and schistosomiasis. In: Disease Control Priorities. 3rd ed. Washington DC: World Bank; 2018.
11. Prendergast AJ, Humphrey JH. The stunting syndrome in developing countries. Matern Child Nutr. 2019;15(S1):e12752.
12. Keusch GT, Rosenberg IH, Denno DM, et al. Implications of environmental enteric dysfunction for child health. Clin Infect Dis. 2020;71(8):196–204.
13. Djuardi Y, Wammes LJ, Supali T, Sartono E, Yazdanbakhsh M. Soil-transmitted helminth infection and nutritional status among children in East Nusa Tenggara, Indonesia. PLoS Negl Trop Dis. 2021;15(2):e0009506.
14. Olin F, Kedang B, Bia B. Helminth infection and growth outcomes among school-aged children in South Central Timor. BMC Public Health. 2020;20:1423.
15. De Silva NR, Brooker S, Hotez PJ, et al. Soil-transmitted helminth infections: updating the global picture. Trends Parasitol. 2020;36(1):45–54.
16. Salam RA, Cousens S, Welch V, et al. Effectiveness of deworming interventions on child nutritional outcomes. BMJ Glob Health. 2022;7:e008090.
17. Welch VA, Ghogomu E, Hossain A, et al. Mass deworming for soil-transmitted helminths. Cochrane Database Syst Rev. 2023;6:CD000371.
18. Nikolay B, Brooker SJ, Pullan RL. Sensitivity of diagnostic methods for soil-transmitted helminth infections. Parasit Vectors. 2020;13:144.
19. Cools P, Vlaminck J, Albonico M, et al. Diagnostic challenges in low-intensity soil-transmitted helminth infections. PLoS Negl Trop Dis. 2021;15(1):e0008966.
20. Katona P, Katona-Apte J. The interaction between nutrition and infection. Clin Infect Dis. 2020;46(10):1582–1588.
    (classic immunonutrition reference)
21. Schaible UE, Kaufmann SH. Malnutrition and infection: complex mechanisms and global impacts. Nat Rev Immunol. 2019;7(9):673–685.
22. Improving child nutrition: the achievable imperative for global progress. New York: UNICEF; 2022.
23. World Health Organization. WASH and neglected tropical diseases: global strategy 2021–2030. Geneva: WHO; 2021.
24. UNICEF, WHO, World Bank. Joint child malnutrition estimates 2023 edition. Geneva: WHO; 2023.
25. Ministry of Health Republic of Indonesia. National strategy for acceleration of stunting reduction 2024–2030. Jakarta: MoH RI; 2024.