• Humans
• Ethiopia/epidemiology
• Health Knowledge, Attitudes, Practice
• Male
• Female
• Cross-Sectional Studies
• Adult
• Soil/parasitology
• Middle Aged
• Helminthiasis/prevention & control
• Helminthiasis/epidemiology
• Helminthiasis/transmission
• Young Adult
• Rural Population
• Adolescent
• Surveys and Questionnaires
• Animals
• Hand Disinfection
• Helminths/isolation & purification

Soil-transmitted helminths are a common public health problem in Ethiopia, affecting all age groups. However, epidemiological studies and interventions primarily target school-age children, despite the fact that 44.6 million adults live in endemic areas. Hence, data on the prevalence and intensity of soil-transmitted helminths infections and associated factors among adolescents and adults helps to expand interventions.

The aim of the study was to assess the prevalence and intensity of soil-transmitted helminths and associated factors among adolescents and adults in Bibugn Woreda, East Gojjam, Northwest Ethiopia.

A community-based cross-sectional study was conducted in Bibugn Woreda from February to September 2021. Using multistage proportionate sampling technique, 641 adolescents and adults were enrolled in this study. Data on sociodemographic characteristics and factors associated with helminthic infections was collected using structured questionnaire prepared in Amharic and administered through face-to-face interview. Parasite detection in stool samples was performed using modified formol-ether concentration and Kato-Katz techniques following standard protocols. Data was entered and analyzed using Statistical Package for the Social Sciences software version 25. Multivariable logistic regression was used to assess factors associated with soil-transmitted helminths infections. P value <0.05 was considered as statistically significant.

The overall prevalence of soil-transmitted helminths infection was 20.9% (134/641). The most detected parasite was Ascaris lumbricoides (12.5%), followed by hookworm species (7.5%) and Trichuris trichiura (1.1%). Fecal egg counts revealed that 96.5% (112/116) of the infections were with light parasite intensity, while 3.5% (4/116) were with moderate parasite intensity. Family size >5 (AOR = 1.866; 95% CI: 1.221–2.853; P=0.004), absence of latrine (AOR = 3.675; 95% CI: 1.599–8.449; P=0.002), and no habit of hand washing before meal (AOR = 2.622; 95% CI: 1.073–6.405; P=0.034) were significantly associated with soil-transmitted helminths infections.

There was moderate prevalence of soil-transmitted helminths among adolescents and adults with predominance of A. lumbricoides. Family size greater than five, absence of latrine, and no hand washing habit before meal predisposed adolescents and adults for soil-transmitted helminths. The existing school-based interventions should expand to address adolescents and adults.

Studies have shown that households using sludge from human excreta for agriculture are at an increased risk of soil transmitted helminths. However, while use of ecological sanitation (EcoSan) latrines is increasing in most African countries including Malawi, few studies have been done to check whether use of such sludge could potentially increase the prevalence of helminthic infections among household members as a results of exposure to faecal sludge/compared to use of traditional latrines.

A cross sectional study was done targeting households using EcoSan and traditional pit latrines. Samples were collected from both types of latrines in Chikwawa (rural) and Blantyre (urban) districts. These two districts have a high number of EcoSan latrines in southern region of Malawi. 156 latrines were sampled (n = 95 traditional; n = 61 EcoSan), and processed following standard guidelines using modified triple floatation method. Identification of helminth ova (Ascaris lumbricoides, hookworms, Trichuris trichiura, Taenia spp. and Diphyllobothrium latum) was done using standard microscopy methods. The difference between the prevalence and mean concentration of helminths between the two types of latrines was tested using Chi Square and t test respectively.

Of the total latrines tested, 85.9% (n = 134) had at least one species of helminth while 84.6% (n = 132) had at least a STH, with 82.0% (n = 50) in EcoSan and 86.3% (n = 82) in traditional pit latrines. There was no significant difference between the prevalence of helminths in EcoSan and traditional pit latrines [χ² = 0.43 (1), P = 0.5]. The prevalence of Ascaris lumbricoides was significantly higher in EcoSan than in traditional pit latrines [χ² = 5.44 (1) p = 0.02] while prevalence of hookworms was significantly higher in traditional pit latrines than in EcoSan latrines [χ² = 13.98 (1) p < 0.001]. The highest concentration of helminths per gram of faecal sludge was in traditional pit latrines [31.2 (95% CI 19.1–43.2)] than in EcoSan latrines [26.4 (95% CI 16.5–36.3)].

There was no significant difference between overall prevalence of helminths between households using EcoSan and those using traditional pit latrines. However, Ascaris lumbricoides was significantly higher in households using EcoSan latrines. EcoSan users need awareness on safe ways of handling faecal sludge in order to reduce chances of reinfection from Ascaris lumbricoides. Further research should be undertaken on household members to identify those infected and potential routes of infection to enable preventive targeting.

• Ascaris lumbricoides
• EcoSan
• Human faecal matter and risk
• Pit latrines
• Soil transmitted helminths

• Ascariasis
• Ascaris
• Diagnosis
• Immunology
• Microscopy
• PCR

Ascaris lumbricoides infection is rare among children in developed countries. Although large numbers of adult Ascaris in the small intestine can cause various abdominal symptoms, this infection remains asymptomatic until the number of worms in the intestine considerably increases in most cases. Ascaris causing bilious vomiting suggesting ileus is rare, especially in developed countries. A 6-year-old boy who lived in Japan, presented with abdominal colic, bilious vomiting at the pediatric emergency room. He appeared pale, and had no abdominal distention, tenderness, palpable abdominal mass, or findings of dehydration. He experienced bilious vomiting again during a physical examination. Laboratory tests showed mild elevation of white blood cells and C-reactive protein levels. Antigens of adenovirus, rotavirus, and norovirus were not detected from his stool, and stool culture showed normal flora. Ultrasonography showed multiple, round-shaped structures within the small intestine, and a tubular structure in a longitudinal scan of the small intestine. Capsule endoscopy showed a moving worm of Ascaris in the jejunum. Intestinal ascariasis should be considered as a cause of bilious vomiting in children, even at the emergency room in industrial countries. Ultrasound examination and capsule endoscopy are useful for diagnosis of pediatric intestinal ascariasis.

• Ascaris lumbricoides
• Paralytic ileus
• Capsule endoscopy
• Ultrasound
• Bilious vomiting

• Animals
• Antinematodal Agents/therapeutic use
• Ascariasis/complications
• Ascariasis/diagnosis
• Ascariasis/drug therapy
• Ascariasis/parasitology
• Ascaris lumbricoides/drug effects
• Ascaris lumbricoides/isolation & purification
• Capsule Endoscopy
• Child
• Emergency Service, Hospital
• Humans
• Intestinal Diseases, Parasitic/complications
• Intestinal Diseases, Parasitic/diagnosis
• Intestinal Diseases, Parasitic/drug therapy
• Intestinal Diseases, Parasitic/parasitology
• Intestinal Pseudo-Obstruction/parasitology
• Japan
• Jejunum/diagnostic imaging
• Jejunum/drug effects
• Jejunum/parasitology
• Male
• Predictive Value of Tests
• Pyrantel Pamoate/therapeutic use
• Treatment Outcome
• Ultrasonography
• Vomiting/parasitology