Analysis of Risk Factors and Mapping of Helminth Infection Incidence in the Working Area of Nulle Public Health Center, South Central Timor Regency

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.