High Burden of Soil-Transmitted Helminth Infections among Preschool and School Aged-Children in North Kodi, Southwest Sumba, Indonesia: A Cross-Sectional Study

5 Soil-transmitted helminth (STH) infections remain a significant global health concern due to their high prevalence in many areas and ease of transmission via the fecal-oral route. To control and enhance the declining helminth infection rate in children, Indonesia initiated a nationwide mass drug administration (MDA) in 2017, encompassing rural areas such as Southwest Sumba (SWS). Nevertheless, the prevalence of STH in SWS remained at 54% by 2021. Children are particularly susceptible owing to frequent exposure to helminth-egg-contaminated environments, which may lead to nutrient deficiencies. Therefore, we sought to assess STH prevalence in this post-MDA period and to investigate the impact of STH infection on anemia, nutritional status, and hygiene practices among preschool-aged children (PAC) and schoolaged children (SAC) in Hameli Ate and Homba Karipit Villages, North Kodi District. A total of 223 stool samples were examined using the Kato-Katz technique, revealing an overall STH prevalence of 58.3%, with the majority of children exhibiting light infections (Ascaris lumbricoides: 37.7%; Trichuris trichiura: 26.5%). Infection rates were notably higher in younger SAC (26.6%; 34/128) and older SAC (40%; 10/25) compared to PAC (21.1%; 8/38) groups. Despite this, 67.9% of the children had normal nutritional status, and 61.5% were found to be non-anemic. There was a significant correlation between maternal education and STH infections (OR = 0.4; 95%CI = 0.2-0.79; p = 0.016). A highly educated mother would improve children's hygiene, subsequently contribute to the reduction of infection severity and enhance the child's health. Altogether, our findings indicate the high burden of STH infection on children in this rural area. Thus, this study emphasize the importance of the re-evaluation of the MDA program and improvement of hygiene facilities, such as clean water and sanitation, to mitigate disease risk and promote children's health.