Effectiveness of Drug-Based Interventions and Integrated Community Strategies for Soil-Transmitted Helminth Control in Southeast Asia: A Systematic Review

Soil-transmitted helminth (STH) infections continue to pose a significant health threat in Southeast Asia (SEA), where a third of global STH infections are estimated to occur. Preventive chemotherapy (PC) through mass treatments has been recommended by the WHO to combat STH infections and their dire consequences in susceptible populations. This review aims to update PC efforts for STH infection control in SEA. We systematically searched MEDLINE via PubMed, ScienceDirect, Scopus, EBSCO Host and ProQuest using specific terms for papers published from 2011 through 2025. From the 4294 initial search hits, 27 studies were included in this research. All SEA countries, except Brunei Darussalam and Singapore, were represented. Benzimidazole (BZ) drugs, namely, albendazole (400 mg) and mebendazole (500 mg), were the most commonly used drug interventions in PC efforts. BZ treatment effectively reduced the prevalence and intensity of STH infections, reinforcing its role in control programs. However, recent research has shown that BZ treatments fail to reduce infection prevalence and have diminished efficacy. Combination therapies, such as ivermectin (200 µg/kg) + albendazole (400 mg), enhanced treatment outcomes across STH species. Combination therapy integrated with health education and water, sanitation and hygiene improvement can accelerate control and elimination. Our review provides valuable insights for strengthening STH control programs in SEA, advocating for a multi-faceted approach informed by the current evidence.